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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">clinmed</journal-id><journal-title-group><journal-title xml:lang="ru">Клиническая медицина</journal-title><trans-title-group xml:lang="en"><trans-title>Clinical Medicine (Russian Journal)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0023-2149</issn><issn pub-type="epub">2412-1339</issn><publisher><publisher-name>ООО «Медицинское информационное агентство»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30629/0023-2149-2025-103-1-58-67</article-id><article-id custom-type="elpub" pub-id-type="custom">clinmed-1047</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ДИСКУССИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>DISCUSSION</subject></subj-group></article-categories><title-group><article-title>Эволюция врачебной профессии: от патерналистской модели к современным представлениям о профессиональной роли врача</article-title><trans-title-group xml:lang="en"><trans-title>The evolution of the medical profession: from the paternalistic model towards modern ideas about the professional role of a doctor</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1499-5582</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Беленькова</surname><given-names>Ю. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Belenkova</surname><given-names>Yu. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Беленкова Юлия Борисовна — студентка 6-го курса факультета лечебное дело,</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Yulia B. Belenkova — a 6th-year student at the Faculty of Medicine</p><p>St. Petersburg</p></bio><email xlink:type="simple">pfanmp@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>North-Western State Medical University named after I.I. Mechnikov, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>08</day><month>05</month><year>2025</year></pub-date><volume>103</volume><issue>1</issue><fpage>58</fpage><lpage>67</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Беленькова Ю.Б., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Беленькова Ю.Б.</copyright-holder><copyright-holder xml:lang="en">Belenkova Y.B.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.clinmedjournal.com/jour/article/view/1047">https://www.clinmedjournal.com/jour/article/view/1047</self-uri><abstract><p>В статье анализируются вопросы становления и развития врачебной профессии в конкретных исторических условиях общественного развития, а также с позиций социокультурной эволюции профессии врача, раскрываются особенности формирования патерналистской модели отечественной медицины — ее прообразом служит феномен «земской медицины», черты которой прослеживаются и в современной медицинской практике. Особый акцент в работе сделан на анализе типологий взаимоотношений в системе «врач–пациент», исследуются классические и альтернативные модели таких взаимоотношений. Характеризуются процессы трансформации роли врача в условиях информационного общества, диктующего новые требования к его профессиональной компетентности, включающей базовые (теоретические, практические, технические) и универсальные (индивидуально-личностные, социально-волевые) компетенции. Даются обоснованные и развернутые выводы об эволюции врачебной профессии от патерналистской модели к современному пониманию роли врача в реалиях нового времени и поиску оптимального типа гармоничных и результативных отношений между врачом и пациентами, коллегами, руководством.</p></abstract><trans-abstract xml:lang="en"><p>This article analyzes the issues of the formation and development of the medical profession within specific historical contexts of social development, as well as from the perspective of the sociocultural evolution of the medical profession. It reveals the characteristics of the formation of the paternalistic model of domestic medicine, which is exemplifi ed by the phenomenon of “zemstvo medicine,” traces of which can still be seen in contemporary medical practice. Special emphasis is placed on analyzing the typologies of relationships in the “physician-patient” system, exploring both classical and alternative models of such relationships. The processes of transformation of the physician’s role in the context of an information society are characterized, highlighting new demands for professional competence that include basic (theoretical, practical, technical) and universal (individual-personal, social-volitional) competencies. Well-founded and detailed conclusions are drawn regarding the evolution of the medical profession from a paternalistic model to a modern understanding of the physician’s role in the realities of contemporary times, as well as the search for an optimal type of harmonious and eff ective relationships between physicians and patients, colleagues, and management.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>эволюция</kwd><kwd>врачебная профессия</kwd><kwd>патернализм</kwd><kwd>профессиональная роль</kwd><kwd>информационное общество</kwd></kwd-group><kwd-group xml:lang="en"><kwd>evolution</kwd><kwd>medical profession</kwd><kwd>paternalism</kwd><kwd>professional role</kwd><kwd>information society</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование не имело спонсорской поддержки.</funding-statement><funding-statement xml:lang="en">The study had no sponsorship.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Баклушина Е.К., Бурсикова Д.В., Пануева Н.Н. 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