Addressing dual agency: getting specific about the expectations of professionalism

Tilburt, J.C.
Submitted: January, 2014

Professionalism requires that physicians uphold the best interests of patients while simultaneously insuring just use of health care resources. Current articulations of these obligations like the American Board of Internal Medicine (ABIM) Foundation’s Physician Charter do not reconcile how these obligations fit together when they conflict. This is the problem of dual agency. The most common ways of dealing with dual agency: “bunkering”–physicians act as though societal cost issues are not their problem; “bailing”–