Table 1
Participant demographics by stakeholder group.
| STAKEHOLDER GROUP | n | GENDER (F/M) |
|---|---|---|
| General public | 33 | 22/11 |
| Medical trainees | 20 | 9/11 |
| Physicians (attendings/residents/PGY) | 25 | 2/23 |
| Total | 78 | 33/45 |
[i] *Ethnic background was not collected, in accordance with IRB guidance, to protect confidentiality in small focus groups and avoid potential identification of participants in sensitive discussions.
Notes: Data collection occurred December 2015–May 2016; average session duration ≈ 1.5 hours; number of focus groups—public (6), medical trainees (3), physicians (5).
Table 2
Divergent Constructions of Medical Professionalism Across Public and Clinical Stakeholder Perspectives in Taiwan.
| THEME | SUBTHEME | PUBLIC PERSPECTIVE | PHYSICIAN/INTERN PERSPECTIVE |
|---|---|---|---|
| Core Values Underpinning Professionalism | 1. Humanism-Based Care | Warmth and moral virtue define a good doctor. | Compassion is essential, but emotional boundaries are necessary to prevent burnout. |
| 2. Family-Centered Empathy | Family inclusion in decision-making is a sign of respect and professionalism. | Ethical tension between cultural norms and patient autonomy as taught in training. | |
| 3. Moral Character and Role Modeling | Physicians should serve as ethical exemplars in society. | Role modeling by seniors is more influential than formal professionalism instruction. | |
| Expected Competencies and Behaviors | 4. Communication Skills | Friendly tone, patience, and clarity are central to professionalism. | Communication must balance empathy with time constraints and clinical efficiency. |
| 5. Emotional Labor | Professionals should always show emotional availability, regardless of fatigue. | Empathy fatigue is a major challenge; emotional labor is often invisible and draining. | |
| 6. Honesty and Transparency | Full disclosure is a moral duty, even for bad news. | Selective truth-telling is sometimes necessary to protect patients or avoid conflict. | |
| 7. Technical Competence and Lifelong Learning | Competence is assumed; humanistic care distinguishes professionals. | Continuous learning is a core professional obligation in an evolving medical field. | |
| 8. Accountability and Responsibility* | Physicians should personally own up to errors. | Responsibility is often shared across teams; systemic issues contribute to mistakes. | |
| 9. Peer Respect and Teamwork | Rarely discussed; professionalism seen as primarily patient-facing. | Respect across hierarchies is vital, but juniors often hesitate to challenge seniors. | |
| Cultural and Systemic Tensions Shaping Professionalism | 10. Service Industry vs. Ethical Autonomy | Physicians should act like service providers and accommodate patient demands. | Physicians prioritize ethical autonomy over customer-service expectations. |
| 11. Family vs. Individual Autonomy | Family-first decision-making protects patients and reflects cultural norms. | Family involvement is culturally expected but can conflict with legal and ethical norms. |
[i] *Note: Although positioned under Theme 2, this subtheme also intersects with Theme 3, as accountability is shaped not only by individual professional behaviors but also by broader cultural expectations and systemic realities.