In reply: Medical professionalism project

In reply: I welcome the comments on the physicians' charter. The purpose in publishing the charter was to promote a dialogue on medical professionalism, as, in contrast to the continuing discussion and debate on professionalism in North America1-3 and the United Kingdom,4 interest in the subject in Australia is virtually absent. Enter the terms "medical professionalism" and "Australia" in PubMed and the search yields eight publications in the Australian literature over the past 30 years. Despite this meagre tally, Breen informs us that all is well, through the efforts of bodies such as the Australian Medical Council (AMC). While the AMC's efforts are commendable, its recommendations for instilling professional attitudes in medical students and interns must compete with other priorities in an already crowded curriculum and with the pressures of the intern year. Under the daily stresses of real life, abstract concepts of professionalism are likely to be given low priority. Breen also suggests that the medical colleges are "poised to do more in this area". This may be so, but a search of college websites reveals that most are silent on matters of professionalism. Finally, Breen laments that the physicians' charter contains nothing new — but no one really expects revolutionary concepts in precepts of professionalism, which have evolved over hundreds of years. Besides, what harm is there in being exposed to the views of our colleagues in the northern hemisphere? As the comments of Gruen suggest, the charter is one of the more broad-ranging contemporary expositions of medical professionalism.