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Today's definition of medical professionalism is evolving - from autonomy to accountability, from expert opinion to evidence-based medicine, and from self-interest to teamwork and shared responsibility. For many, medical professionalism is the "heart and soul of medicine." More than the adherence to a set of medical ethics, it is the daily expression of what originally attracted them to the field of medicine - a desire to help people and to help society as a whole by providing quality health care. But many physicians today experience profound obstacles to fulfilling the ideals of medical professionalism in practice.

"I think it is safe to say that no physician is optimistic about the future of medicine at this point," one participant wrote. Others seemed downright hopeless...the practice of medicine continually gets worse and worse, more intolerable, more onerous, with absolutely no hope or reason for any optimism either in the near or remote future."