Professionalism in

MedicineBy

Dr. Mohammed O. Al-Rukban

Associate Professor Family Medicine

Consultant

Do You Still Remember A Role Model Who Influenced Your Training?

If Yes? Mention Some of Their Qualities and Attributes.

What does professionalism means to you?

• Take a few minutes and write down your thoughts … as a definition or description.

What is Professionalism?• It is not easy to define a profession, but it

is likely to have all or Some of the following characteristics:– It is a vocation or calling that implies service to

others– It has a distinctive knowledge base which is kept

up to date– It determines its own standards and sets its own

examinations– It has a special relationship with those whom it

serves e.g. patients, students….– It has particular ethical principles

• Professionalism is a term which embodies numerous qualities of physicians as public servants.

• It has been described by The American Board of Internal Medicine (ABIM) as:

“Constituting those attitudes and behaviors that serve to maintain others interest above physician Self-interest”

بطبعه مهنٌي المسلم الطبيب“ويؤثرون على أنفسهم ولو كان بهم خصاصة”“إن الله يحب من العامل إذا عمل أن يتقن”“.........إذا ذبحتم فأحسنوا الذبحة” ال يؤمن أحدكم حتى يحب ألخيه ما يحب ”

لنفسه..“

'Project Professionalism' (ABIM, 2001)

Developed the Physician Charter and identified six key elements of professionalism:

1- Altruism (giving priority to patient interests rather than self-interests);

2- Accountability (being answerable to patients, society and profession);

3- Excellence (conscientious effort to perform beyond ordinary expectation, and commitment to life-long learning);

'Project Professionalism' (ABIM, 2001)

4- Duty (free acceptance of commitment to service – i.e. undergoing inconvenience to achieve a high standard of patient care);

5- Honor and integrity (being fair, truthful, straightforward, and keeping to one's work);

6- Respect for other (respect for patients and families, colleagues, other healthcare professionals and students and trainees).

The concept of professionalism includes the following values:

HonestyTrustServiceCommitment

CommunicationAccountabilityLife-long learning

Defining Professionalism

What specific behaviors are unprofessional in

classroom and clinical settings?

Examples of Unprofessional Behaviors

Classroom Setting-Students/Trainee

• Arriving for class late and/or leaving early• Being unprepared for group sessions• Not completing assigned tasks• Disrupting class sessions• Failing to attend scheduled class sessions• Cheating on an exam

Examples of Unprofessional Behaviors

Classroom Setting-Students/Trainees

• Using Mobile Phone during class• Chatting during class• Focusing on the test vs. learning• Prejudging content in advance• Intolerance of the opinions of others

Examples of Unprofessional Behaviors

Classroom Setting-Faculty• Plagiarism• Judgmental attitude or favoritism• Coming late• Sloppy handouts and syllabi• Abusive behavior• Using Mobile Phone during class

Examples of Unprofessional Behaviors:

Clinical Setting-Students

• Dressing inappropriately• Avoiding work and/or responsibilities• Exhibiting little empathy for patients• Demonstrating lack of sensitivity to patients’

cultural backgrounds• Not protecting patient confidentiality

Examples of Unprofessional Behaviors:

Clinical Setting: Faculty • Showing favoritism • Failing to attend scheduled sessions• Using inappropriate language or behavior• Asking learners to perform personal tasks, for

example, picking up laundry

Common Examples• Marketing for a new drug?• Conflicts between government vs private

commitments.

Signs and Symptoms The work of Project Professionalism

(ABIM, 2001) describes unprofessional behaviour in terms of seven broad categories of 'signs and symptoms'.

1- Abuse of power (abuse while interacting with patients and colleagues; bias and sexual harassment; and breach of confidentiality);

2- Arrogance (offensive display of superiority and self-importance);

3- Greed (when money becomes the driving force);

Signs and Symptoms4- Misrepresentation (lying, which is

consciously failing to tell the truth; and fraud, which is conscious misrepresentation of material fact with the intent to mislead);

5- Impairment (any disability that may prevent the physician from discharging his/her duties);

6- Lack of conscientiousness (failure to fulfill responsibilities);

7- Conflicts in interests (self-promotion/ advertising or unethical collaboration with industry; acceptance of gifts; and misuse of services – overcharging, inappropriate treatment or prolonging contact with patients).

How professionalism can be implemented?

Professionalism• Role of the doctor within

the health service– Understanding of the

health care system– Understanding of clinical

responsibilities– Appreciation of doctor as

researcher– Appreciation of doctor as

mentor or teacher– Appreciation of doctor as

manager including quality control

– Team working

• Personal Development– Lifelong Learner– Self awareness– Self confidence– Self regulation

• Self care• Self control• Personal time

management– Motivation

• Achievement drive• Commitment• initiative

– Career choice

Take Home Messages• Professionalism should be part of the

formal curriculum• Professionalism must be taught and

assessed• Professionalism must be relevant to the

society it serves

Final Word “There is a tendency to

underemphasize the personal characteristics… , because they are harder to measure, and to overemphasize the more easily measured indices of academic

achievement” Cohen (2002)