Despite a robust literature on the topic, a consistent definition of medical professionalism remains elusive. A single, generalizable definition is ineffective and tends to emphasize prohibited behaviors rather than aspirational concepts. As physicians are increasingly employed by corporate entities, the nature of healthcare work has changed, as well as professional expectations. This study explores how patients and family physicians understand medical professionalism and its drivers. We recruited family physicians who completed the ABFM Continuing Certification Questionnaire in 2024 to participate in in-depth, semi-structured interviews. A trained qualitative researcher used Zoom to interview 27 demographically diverse physicians. We utilized modified snowball sampling to recruit patients through a key informant. All interviews were transcribed verbatim and analyzed utilizing NVivo software following an inductive content analysis approach. Interview results coalesced into a model of professionalism that represents the clinic visit, the practice site, and the overarching system. Three main components of individual physician professionalism emerged, including foundational duties, relationship-based care, and communication. Patient trust in the overarching healthcare system and individual physicians was deeply influenced by the interconnected system. This study presents key elements of physician professionalism while highlighting how deeply physicians are entangled within the larger practice and healthcare systems. Professionalism extends beyond-and is impacted by-more than individual attitudes and behaviors. Institutions must interrogate their own policies to support physicians in developing their skills in relationship-based care and communication.