Full-text resources of CEJSH and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl


2017 | 36(1) | 43-62

Article title

Durability of some ideas. The unfulfilled promises of professionalism


Title variants

Durability of some ideas. The unfulfilled promises of professionalism

Languages of publication



Artykuł przedstawia koncepcję profesjonalizmu jako odpowiedź na ważne pytanie poli-tyki zdrowotnej o metodę organizowania społecznych relacji, w tym stosunków władzy. Przedstawione zostały zmiany, jakie dokonały się w podejściu do profesjonalistów medycznych, poczynając od tradycyjnej koncepcji wychwalającej profesjonalizm, dalej jej krytykę, przez uznanie profesjonalizmu za narzędzie regulujące stosunki społeczne i organizacyjne, a także za ideologię, a następnie ideę opieki zarządzanej i konsumeryzm medyczny, kończąc na kryzysie profesjonalizmu i jego odrodzeniu, w postaci nowego profesjonalizmu. Pokazano wpływ na zmiany relacji lekarz-pacjent, gdzie w miejsce biernego pacjenta pojawił się aktywny klient, a pozycja lekarzy jako niezależnej profesji uległa osłabieniu.
This article presents the concept of professionalization as the response to important questions of health policy on methods of organizing social relations, including the relations of political power. The author presented changes in the attitude of medical professionals, starting with the traditional conceptions, which extolled professionalism. Then the author presented their criticism, including considering professionalism to be the tool regulating social and organizational relations, ideology and medical consumerism, ending with the crisis of professionalism and its rebirth in the form of a new professionalism. Finally the author discussed the impact of changing relations between doctors and patients; a passive patient was replaced by an active client and the doctor's position as an independent professional decreased.


  • Instytut Zdrowia Publicznego, Wydział Nauk o Zdrowiu
  • Uniwersytet Jagielloński Collegium Medicum


  • Baker, R. (2005). Placing principle before expediency: the Shipman Inquiry. Lancet, March, vol. 365, s. 919-921, DOI: http://dx.doi.org/10.1016/S0140-6736(05)71059-X [dostęp 9.01.2017].
  • Bishop, F.L., Barlow, F., Coghlan, B., Lee, P., Lewith, G.T. (2011). Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK. BMC Health Services Research, May. Pobrano z: http://bmchealthservres.biomed- central.com/articles/10.1186/1472-6963-11-129 [dostęp 9.01.2017].
  • Blumenthal, D. (1994). The vital role of professionalism in health care reform. Health Affairs, vol. 13, no. 1, s. 252-256.
  • Bordass, B., Leaman, A. (2012). A new professionalism: remedy or fantasy? Building Rese- arch & Information, December, vol. 41, no. 1, s. 1-7. Pobrano z: http://www.tandfon- line.com/doi/pdf/10.1080/09613218.2012.750572?needAccess=true [dostęp 9.01.2017].
  • Braithwaite, J. et al. (2006). New professionalism in the 21st century. Lancet, February, vol. 367, no. 9511, s. 645-649.
  • Capitulo, K.L. (2009). Addressing disruptive behavior by implementing a code of profes- sionalism to transform hospital culture. Nurse Leader, April, vol. 7, no. 2, s. 38-43, DOI: http://dx.doi.org/10.1016/j.mnl.2009.01.009 [dostęp 9.01.2017].
  • Coleman, V. (2014). Meet the bloated, useless General Medical Council. The Spectator, October. Pobrano z: http://www.spectator.co.uk/2014/10/get-rid-of-the-gmc/ [dostęp 9.01.2017].
  • Consumer Reports (2012). How safe is your hospital? Our new Ratings find that some are riskier than others. Consumer Reports Magazine, August. Pobrano z: http://www.con- sumerreports.org/cro/magazine/2012/08/how-safe-is-your-hospital/index.htm [dostęp 9.01.2017].
  • Cruess, R.L., Cruess, S.R., Johnston, S.E. (2000). Professionalism: an ideal to be susta- ined. Lancet, July, vol. 356, s.156-159 DOI: 10,1016 / S0140-6736 (00) 02458-2 [dostęp 9.01.2017].
  • Dixon-Woods, M., Yeung, K., Bosk, Ch.L. (2011). Why is UK medicine no longer a self- -regulating profession? The role of scandals involving „bad apple” doctors. Social Science & Medicine, November, vol. 73, no. 10, s. 1452-1459, DOI:10.1016/j.socsci- med.2011.08.031 [dostęp 9.01.2017].
  • Emanuel, Z., Sharfstein, J., Spiro, T., O'Toole, M. (2016). State options to control health care costs and improve quality. Center for American Progress, April. Pobrano z: https:// cdn.americanprogress.org/wp- content/uploads/2016/04/07050836/CostContainment- -report.pdf [dostęp 9.01.2017].
  • Evetts, J. (2011). A new professionalism? Challenges and opportunities. Current Sociology, July, vol. 59, no. 4, s. 406-422.
  • Evetts, J. (2012). Professionalism: Value and ideology. Sociopedia.isa, DOI: 10.1177/ 205684601231. Pobrano z: http://www.sagepub.net/isa/resources/pdf/Professionalism. pdf [dostęp 9.01.2017].
  • Figueras, J., Robinson, R., Jakubowski, E. (red.). (2005). Purchasing to improve health systems performance. European Observatory on Health Systems and Policies series. Open University Press. Pobrano z: http://www.euro.who.int/__data/assets/pdf_file/0004/98428/ E86300.pdf?ua=1 [dostęp 9.01.2017].
  • Freidson, E. (1970a). Professional dominance: The social structure of medical care. New York: Atherton Press.
  • Freidson, E. (1970b). Profession of medicine: A study in the sociology of applied knowledge. New York: Dodd, Mead.
  • Freidson, E. (2001). Professionalism: the third logic. On the practice of knowledge. Chicago: University of Chicago Press.
  • Hall, R.H. (1968). Professionalism and bureaucratization. American Sociological Review, February, vol. 33, no. 1, s. 92-104.
  • Hashimoto, N. (2006). Professional autonomy. Japan Medical Association Journal, March, vol. 49, no. 3. Pobrano z: http://www.med.or.jp/english/pdf/2006_03/125_127.pdf [dostęp 9.01.2017].
  • Herrick, D. (2010). Why health costs are still rising. National center for policy analysis, November, vol. 18, no. 731. Pobrano z: http://www.ncpa.org/pdfs/ba731.pdf [dostęp 9.01.2017].
  • Hodges, B.D. et al. (2011). Assessment of professionalism: Recommendations from the Ottawa 2010 Conference. Medical Teacher, 25 April, vol. 33, no. 5, s. 354-363.
  • Illich, I. (1976). Medical nemesis: The expropriation of health. New York: A Division of Random House.
  • Illich, I., Zola, I.K., McKnight, J., Caplan, J., Shaiken, H. (1977). Disabling professions. London: Marion Boyars.
  • Jayanth, A. (2015). Consumers vs. patients: Healthcare's biggest misunderstanding. Health Information Technology, February. Pobrano z: http://www.beckershospitalreview. com/healthcare-information-technology/consumers-vs-patients-healthcare-s-biggest- misunderstanding.html [dostęp 9.01.2017].
  • Kohn, L.T., Corrigan, J.M., Donaldson, M.S. (red.) (2000). To err is human: Building a better health care system. Washington: National Academy Press. Pobrano z: https:// www.ncbi.nlm.nih.gov/pubmed/25077248 [dostęp 9.01.2017].
  • Kordel, P. (2012). Geneza, struktura i funkcjonowanie samorządu lekarskiego w Polsce w latach 1989-2009. Rozprawa doktorska. Poznań: Uniwersytet Medyczny. Pobrano z: http://www.wbc.poznan.pl/Content/249327/index.pdf [dostęp 9.01.2017].
  • Lee, C.J. (2008). Does the Internet displace health professionals? Journal of Health Com- munication, vol. 13, no. 5, s. 450-464.
  • Light, D., Levine, S. (1988). The changing character of the medical profession: A theore- tical overview. The Milbank Quarterly, vol. 66, supplement 2: The Changing Character of the Medical Profession, s. 10-32.
  • Light, D. (2005). Countervailing powers. A framework for professions in transition. W: T. Johnson, G. Larkin, M. Saks (red.), Health professions and the state in Europe. London: Routledge, s. 14-23.
  • Mastekaasa, A. (2011). How important is autonomy to professional workers? Professions and Professionalism (P&P), vol. 1, no. 1, s. 36-51.
  • Mayo Clinic Model of Care (2014). Mayo Foundation for Medical Education. Pobrano z: http://www.mayo.edu/pmts/mc4200-mc4299/mc4270.pdf [dostęp 9.01.2017].
  • Mechanic, D. (2000). Managed care and the imperative for a new professional ethic.
  • Health Affairs, vol. 19, no. 5, s. 100-111.
  • Muzio, D., Kirkpatrick, I. (2011). Introduction: Professions and organizations — a con- ceptual framework. Current Sociology, vol. 59, no. 4, s. 389-405.
  • National Institute for Health and Care Excellence (2017). Pobrano z: https://www.nice.org.uk [dostęp 9.01.2017].
  • OECD (2010). Health care systems: Getting more value for money. OECD Economics Department Policy Notes, no. 2. Pobrano z: https://www.oecd.org/eco/growth/46508904. pdf [dostęp 9.01.2017].
  • Ottesen, E., M0ller, J. (2016). Organisational routines — the interplay of legal standards and professional discretion. European Educational Research Journal, vol. 15, no. 4, s. 428-446.
  • Owens, J. (2007). Supporting Medical Consumerism. W: Leading practices for employee health management, Partnership for Prevention. Pobrano z: https://www.bcbsnd.com/ documents/10472/6484748/step1-leadingbyexample.pdf/24e97569-cf0c-4354-bce5- e01a4f7ecc4d [dostęp 9.01.2017].
  • Oxley, H., MacFarlan, M. (1995). Health care reform: controlling spending and incre- asing efficiency. OECD Economic Studies, no. 24. Pobrano z: https://www.oecd.org/ eco/growth/33717721.pdf [dostęp 9.01.2017].
  • Packer, S., Burke, M.P. (2003). Professionalism: Questions, old and new. American Journal of Ophthalmology, November, vol. 136, no. 5, s. 921-924.
  • Parsons, T. (1939). Professions and social structure. Social Forces, May, vol. 17, no. 4, s. 457-467.
  • Pearl, R. (2015). Are you a patient or a healthcare consumer? Pharma & Healthcare, October. Pobrano z: http://www.forbes.com/sites/robertpearl/2015/10/15/are-you-a- patient-or-a-health-care-consumer-why-it-matters/#3d016c065c3a [dostęp 9.01.2017].
  • Polacy o państwowej i prywatnej opiece zdrowotnej (2012). Raport CBOS, Warszawa. Pobrano z: http://www.cbos.pl/SPISKOM.POL/2012/K_047_12.PDF [dostęp 9.01.2017].
  • Polder, J.J., Jochemsen, H. (2000). Professional autonomy in the health care system. Theoretical Medicine and Bioethics, September, vol. 21, no. 5, s. 477-491.
  • Protokół końcowy Podzespołu ds. Zdrowia (1989). Porozumienia okrągłego stołu: Warszawa 6 lutego — 5 kwietnia 1989 r., s. 117-132. Pobrano z: http://ofop.eu/sites/ofop.eu/files/ biblioteka-pliki/porozumienia-okraglego-stolu.pdf [dostęp 9.01.2017].
  • Prestige Health Plans (2014). Private Medical Insurance. Pobrano z: http://www.prestige- healthplans.co.uk/private-medical.php [dostęp 9.01.2017].
  • Royal College of Physicians (2005). Doctors in society: Medical professionalism in a chan- ging word, Report of a Working Party, December. Pobrano z: https://cdn.shopify.com/s/ files/1/0924/4392/files/doctors_in_society_reportweb.pdf?15745311214883953343 [dostęp 9.01.2017].
  • Saks, M. (2012). Defining a profession: The role of knowledge and expertise. Professions and Professionalism (P&P), vol. 2, no 1, s. 1-10.
  • Sekhri, N.K. (2000). Managed care: the US experience. Bulletin of the World Health Orga- nization, vo. 78, no. 6. Pobrano z: http://www.who.int/bulletin/archives/78(6)830.pdf [dostęp 9.01.2017].
  • Słońska, Z., Misiuna, M. (1993). Promocja zdrowia. Słownik podstawowych terminów. War-szawa: Agencja Promo-Lider.
  • Smith, S.D. (2007). Physician autonomy in the age of accountability. Minnesota Medicine, October, vol. 90, no. 10, s. 20.
  • Stoeckle, J.D. (1988). Reflections on modern doctoring. The Milbank Quarterly, vol. 66, supplement 2: The Changing Character of the Medical Profession, s. 76-91.
  • Tallinn Charter (2008). Health systems for health and wealth. Pobrano z: http://www.euro. who.int/__data/assets/pdf_file/0008/88613/E91438.pdf [dostęp 9.01.2017].
  • Ustawa z dnia 17 maja 1989 r. o izbach lekarskich. Dz.U. 1989 nr 30 poz. 158. Pobrano z: http://isap.sejm.gov.pl/DetailsServlet?id=WDU19890300158 [dostęp 09.01.2017].
  • Walter, Z., Lopez, M.S. (2008). Physician acceptance of information technologies: Role of perceived threat to professional autonomy. Decision Support Systems, no. 46, s. 206-215. Pobrano z: [dostęp 9.01.2017].
  • Wen, L. (2013). Should you be a „patient” or „healthcare consumer”? Psychology Today, May. Pobrano z: https://www.psychologytoday.com/blog/the-doctor-is-listening/201305/ should-you-be-patient-or-healthcare-consumer [dostęp 9.01.2017].
  • WMA Declaration of Madrid on Professionally-led Regulation (2009). Pobrano z: http://www. wma.net/en/30publications/10policies/r4/index.html [dostęp 9.01.2017].
  • World Medical Association (2017). Pobrano z: http://www.wma.net/en/10home/index.html, [dostęp 9.01.2017].
  • Yiuchi, I. (1997). Professionalism and consumerism: Can they grow together? Editorial.
  • International Journal for Quality in Health Care, vol. 9, no. 6, s. 395-97.
  • Zeigler, H., Kehoe, E., Reismorl, J. (1983). The political power of professionalism: A study of school superintendents and city managers. Eugene: Oregon Univercity, Center for Educational Policy and Management. Pobrano z: http://files.eric.ed.gov/fulltext/ED242051.pdf [dostęp 9.01.2017].
  • Zola, I. (1972). Medicine as an Institution of Social Control. Sociological Review, vol. 20, s. 487-

Document Type

Publication order reference


YADDA identifier

JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.