The change in medical practice. Psycho-social challenges for the profession

This article analyzes imortant changes in medical practice, focusing in those most deeply perceived by a group of physicians from the Metropolitan Region of Santiago, included in ajoint research conducted by the Departments of Psychiatry and Mental Health (East) of the Medical Faculty at the University of Chile and Public Health of the Catholic University of Santiago, during 2003. These are the perceived changes in the relationship between doctors and patients; increased limits in professional autonomy and the fragmentation of medical paractice. Reflecting transformations in social relationships in general, they have added new stress and frustrations, as well as new opportunities and rewards to the medical progression. The perceptions identified are commented within the structural determinants of medical practice. These issues call refreshing discussion on the values supporting medical professionalism and the concept of profession in itself in view of the challenges posed by the current social and cultural changes.