To Be a Professional: How Family Physicians Interpret and Encounter Professionalism

Context: Professionalism is a ubiquitous, fluid, and dynamic concept, particularly within the field of medicine. This is reflected in research, policy briefs, and organizational statements that use the term to describe a range of values and behaviors, including autonomy, emotional intelligence, leadership, a moral compass, and collective organizing. The lack of consensus around the meaning and components of professionalism demands ongoing research and conversation.

Objective: This qualitative research explored how family physicians understand what professionalism means, how it is enacted in their day-to-day practice, and to identify challenges to professionalism.

Study Design: We analyzed eleven interviews with primary care providers recruited from ABFM diplomates who completed a recertification exam in 2023.

Instrument: Interviews were semi-structured and conducted in Summer 2023. Participants were asked about the meaning, value, and components of professionalism. Probing questions were used to elucidate further details and meaning.

Setting/Population Studied: A qualitative researcher used web-conferencing software to interview nineteen geographically and racially diverse early career physicians who self-identify as women. Analysis: All interviews were transcribed verbatim and analyzed utilizing NVivo software following an inductive content analysis approach.

Results: Participants conceptualized professionalism as individualized and highly focused on patient care. They felt their professionalism was supported through family time, mental health support, and regular time off. A loss of ownership over practice decisions, including panel size and documentation, created challenges to professionalism. They valued professionalism for the reputation they gained among both patients and colleagues from other specialties.

Conclusions: These findings suggest that quality patient care remains at the center of professional identity among family physicians and a need for institutions to allow more physician autonomy over key practice decisions. More work needs to disentangle the tensions caused when institutional settings create challenges to professionalism.