Characteristics of the old and new “moral fabric” for physicians. Adapted from Shortell et al.50
| Old expectations | New expectations |
|---|---|
| Physician responsible only for individual patient | Physician responsible for individual patient and populations of patients |
| Individual clinical responsibility for patient | Team or group, and patient, responsibility |
| Credibility and trust largely based on professional mystique and prestige | Credibility and trust based on data and documented evidence of effective practice |
| Profession determines performance and accountability criteria | Profession and others (governments, purchasers, public, community groups, etc) determine performance and accountability criteria |
| Physician accountable to patients and the profession | Physician also accountable to health care organisation and external groups> |
| Organisations exist to serve individual physician's interests | Organisations exist to serve patient, community and physician interests |