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Currently, there is a public perception that self-regulation has gone too far to protect the doctor. Case and Commentary Acting through their professional associations, physicians convinced society that science-based medicine was superior to alternative therapies and that their profession represented a trustworthy moral enterprise [4]. March 29, 2013. Like licensure boards, certification boards set standards for entry, recredentialing, and conduct, and they may also regulate the scope of medical practice [6]. In practice, hospitals and public and private payers regularly use board certification as a criterion for determining who can have privileges and be paid for services. Boukus E, Cassil A, O’Malley A. There is a large discrepancy in knowledge between members of the profession and the general public. Daphne C. Ferrer, MD and Peter M. Yellowlees, MBBS, MD AMA Code of Medical Ethics’ Opinions on Physicians’ Participation in Clinical Research Critics argue, for example, that entry to the profession may be constrained to drive up physician incomes [2]. While predictions are difficult, it is possible to speculate on what the future will hold.First, the demands that have been made for more open and transparent processes will continue and strengthen. However, the focus here will be on formal systems of regulation.Underpinning systems of professional self-regulation in medicine in the US are occupational licensure laws, which grant medicine a monopoly over the practice of medicine. National Medical Associations should assist their members in understanding that self-regulation cannot only be perceived as being protective of physicians, but must maintain the safety, support and confidence of the general public as well as the honour of the profession itself. Patients generally lack the knowledge, skills, or judgment to diagnose or treat disease and, thus, have strong incentives to rely on caregivers with specialized expertise, such as physicians, to assist them. We all know this. The implicit agreement between medicine and society entailing reciprocal rights and obligations has been called a social contract [1,2]. Learning how to self-regulate is an important skill that children learn both for emotional maturity and later social connections. It appears to be incumbent upon both the profession and society to attempt to establish conditions where trust can be maintained. Integral to effective self-regulation is the responsibility and obligation to ensure that these standards are met and to remediate or discipline unethical, immoral, or incompetent practices.The need for self-regulation was reinforced by those studying medicine in the early 1900s who believed that the complexity of the knowledge base and skills required, especially as technology advanced, would make regulation by non-professionals difficult [3,4] and it was thought that the profession could be trusted to carry out this necessary activity. Historically, physicians were subject to guild-style regulations, but these were largely swept away in the Jacksonian era [4]. For its part, the profession must self-regulate in an open and rigorous fashion or it will lose the privilege, and this would be unfortunate for both society and for physicians. While less pronounced than in the past, one longstanding concern is that medicine may abuse self-regulation at the expense of patients and payers [12]. Moreover, self-regulation is a key component in medicine, and during their careers many physicians may be involved in setting, implementing, and possibly enforcing professional standards.From a public policy perspective, the rationale for professional regulation of medicine is patient protection [1]. Copyright 2020 American Medical Association. Biofeedback is a self‐regulation technique through which patients learn to voluntarily control what were once thought to be involuntary body processes.

Because of the ubiquitous nature of systems of professional regulation and their role in defining and enforcing standards of professional conduct, it is important for young medical professionals to understand how they work and the challenges they pose.

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