The College has tackled this with courage and insight. Physicians working within integrated delivery systems have additional responsibilities to make these organizations deliver better care to patients. They are well placed to monitor quality and to determine when policies are compromising good patient care. They can advocate for patients outside of the examination room by participating in quality improvement efforts and striving to incorporate patient preferences and values, thereby improving care provided to the entire population of patients in the plan. In addition, physicians in integrated systems should spearhead initiatives aimed at improving communication and continuity with clinicians in various arenas.
Professionalism demands work at many levels-the patient, the community, and the organization.
The College pays attention to patients, urging physicians to ensure access to quality care for uninsured and insured patients. Future editions should expand on what physicians can do at the community and organizational levels to improve health care for all patients. Ann Intern Med. The metamorphosis of medical ethics. A 30-year retrospective.