How Employment Models Shape Professionalism in General Internal Medicine

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Professionalism in general internal medicine entails patient-centered fiduciary judgment, honesty, and accountability amid real-world constraints.
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Employment policies can shift professionalism from protecting fiduciary judgment toward expectations of organizational alignment and compliance.
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Accommodations are professionally defensible when they protect patients as reasonably possible, honor preferences, communicate limitations, and permit escalation of serious concerns.
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Principled dissent is grounded in duties such as safety, autonomy, justice, honesty, or fiduciary responsibility and remains open to review and correction.
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Organizations share professional obligations to support patient welfare and workforce well-being, communicate honestly, and ensure meaningful accountability.

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