Outside the medical profession, there are various efforts to cut medicine down to size: not only widespread malpractice litigation and massive governmental regulation, but also attempts by consumer groups and others to redefine medicine as a trade rather than as a profession, and the physician as merely a technician for hire under contract. Why should physicians resist such efforts to give the practice of medicine a new meaning? We can gain some illumination from etymology. "Trade," from Germanic and Anglo-Saxon roots meaning "a course or pathway," has come to mean derivatively a habitual occupation and has been related to certain skills and crafts. On the other hand, while "profession" today also entails a habit of work, the word "profession" itself traces to an act of self-conscious and public-even confessional-speech. "To profess" preserves the meaning of its Latin source, to declare publicly; to announce, affirm, avow." A profession is an activity or occupation to which its practitioner publicly professes, that is, confesses, devotion. But public announcement seems insufficient; publicly declaring devotion to plumbing or auto repair would not turn these trades into professions. Some believe that learning and knowledge are the diagnostic signs of a profession. For reasons probably linked to the medieval university, the term "profession" has been applied to the so-called learned professions-medicine, law, and theology-the practices of which are founded upon inquiry and knowledge rather than mere "know how." Yet it is not only the pursuit and acquisition of knowledge that makes one a professional. The knowledge involved makes the profession one of the learned variety, but its professional quality is rooted in something else. Some mistakenly seek to locate that something else in the prestige and honor accorded professionals by society, evidenced in their special titles and the special deference and privileges they receive. But externalities do not constitute medicine a profession. Physicians are not professionals because they are honored; rather, they are honored because of their profession. Their titles and the respect they are shown superficially signify and acknowledge something deeper, that physicians are persons of the professional sort, knowingly and freely devoting themselves to a way of life worthy of such devotion. Just as lawyers devote themselves to rectifying injustices, looking up to what is lawful and right; just as teachers devote themselves to the education of the young, looking up to truth and wisdom; so physicians heal the sick, looking up to health and wholesomeness. Being a professional is thus rooted in our moral nature and in that which warrants and impels making a public confession to a way of life. Professing oneself a professional is an ethical act because it is not a silent and private act, but an articulated and public one; because it promised continuing devotion to a way of life, not merely announces a present preference or a way to a livelihood; because it is an activity in service to some high good that insists on devotion; because it is difficult and demanding. A profession engages one's character and heart, not merely one's mind and hands.