A new report is calling on doctors to be more responsive to patient and public expectations and play a more active role in improving health services. The report, from the King’s Fund, says that in return doctors should be able to expect government and managers to allow them to exercise judgement over clinical priorities and be given a greater role in managing and redesigning health services.The document, “On being a doctor: Redefining medical professionalism for better patient care” says although individual doctors are highly trusted, confidence in the profession as a whole is in danger of being undermined. It highlights a number of challenges facing the profession, including growing public expectations of health care, government demands for more responsive public services, and managers pursuing performance targets.

The report also looks at how medical professionalism can be updated in response to these factors and in anticipation of the report of the Shipman inquiry. One of the report’s authors, Dr Rebecca Rosen said doctors were becoming confused about what it means to be ‘a good doctor’. “They are increasingly frustrated that government reforms that address patient interests – particularly for more convenient care – may jeopardise their ability to practise to the highest clinical standards and disrupt their relationships with patients, ” she added.

The report accepts that a number of changes have already been made, such as reform of the General Medical Council and in closer work between doctors, patients and the general public. It recommends action in three areas, however, in order to strengthen trust in the profession. First it wants to see a new relationship between doctors, patients, government and others concerned with health care and says the medical profession as a whole should take the lead in laying open professional dilemmas and highlighting conflicts of interest. It calls for a strengthening of medical leadership to enable institutions such as the royal colleges and medical schools to take the lead on translating the terms of this new relationship into everyday practice. Finally it wants to see a review of the roles that doctors, managers, government and others play in improving health services to clarify who is best qualified to do what.