Pathways to "Involved Professionalism": Making Processes of Professional Acculturation Intentional and Transparent.

Context - An increase in managerialism and a decrease in trust of the professions have challenged traditional concepts of professionalism. The market model of professionalism espoused by some critics also poses problems for professions, professionals and recipients of professional services. Professional development is now an important component of medical curricula. We believe professionalism is evolving and suggest a concept of involved professionalism as a framework for understanding the complex relationships between professional practice, community and responsibility. Purpose - The purpose of this article is to unpack and compare varying concepts of professionalism, and examine how these concepts can impact on the health care professions and on professional acculturation of new recruits on entry to their medical work environment. Summary - In a changing socio-political climate, traditional notions of professionalism have met criticism in that the autonomy of a profession can disempower the consumers of its service. In New Zealand and elsewhere, market reformers have introduced business oriented decision making structures accompanied by the rhetoric of consumer choice. This shift has constrained the professional decision making ability of medical professionals. Conclusion - We suggest that a further model of professionalism is required to address the challenges of the need for community responsiveness, collaboration, high quality health care and a hospitable professional environment. 'Involved professionalism' ties together knowledge, individual responsibility, collective responsibility and responsiveness to society. It is offered as a framework for health practitioners, policy makers and medical educators.