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The Devil Is in the Details

Paul Batalden, MD; Frank Davidoff, MD

JAMA. 2007;298:1059-1061.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

From the list of 14 characteristics he assembled in 1980, Cyril Houle, a serious student of professional education, singled out self-development as professionalism's one unchanging feature; as he put it, "[A]s an occupational group raises its level of performance . . . its right to call itself a profession increases."¹ Houle's choice of words warrants serious attention: a profession is defined by what it does, not just what it knows, and by doing what it does better all the time, not just doing it well.

Medicine's enormous and highly specialized body of knowledge inarguably makes it a learned profession, but delivering care is performance, not scholarship. In its most basic form, the delivery of science-based care consists of applying generalizable scientific knowledge to the problems of particular patients who are ill, with the result that those patients are better off. Learning to deliver care therefore means going beyond . . . [Full Text of this Article]

Author Affiliations: Center for Evaluative Clinical Sciences, Dartmouth Medical School, Lebanon, New Hampshire (Dr Batalden); and Institute for Healthcare Improvement, Cambridge, Massachusetts (Dr Davidoff).

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