Despite being a “hot-topic” over the last several years, medical professionalism lacks a clear definition. Unfortunately, a muddled understanding of professionalism cannot only affect your career but also the well-being of patients. The healthcare industry has arrived at a general consensus that medical professionalism consists of three pillars: competency in one’s field, ethical practice and service to others.
In 2002, an international group of physicians formed the Physician Charter, which lays out the principles and commitments for medical professionalism among providers. Competency, ethical practice and service make up the essence of the Physicians Charter.
The Cost of Poor Professionalism
In a recent article from American Society of Anesthesiologists, Saundra Curry, M.D. stated, “The cost of not promoting professionalism is high. It includes loss of faith from our patients, loss of respect from our colleagues and gradual erosion of our specialty’s existence.”
Dr. Curry, a Professor at Columbia University, stated, “One of the beauties of professionalism is that it is fluid and changes with shifting mores and situations. One size does not fit all.” Not promoting professionalism results in the loss of faith from patients, colleagues and affects your specialty’s reputation directly. So not just anesthesiologists, but other physician specialties can look for the behaviors one can apply every day to display the three pillars of medical professionalism.
Why Professionalism Matters
In this article, Dr. Curry points to a growing body of literature that supports the idea that patient safety lags when professionalism is poor. Top physicians have lost their jobs due lapses in professionalism that were found to jeopardize the safety of their patients. Medical schools are taking this so seriously that they are implementing professionalism milestones that residents must satisfy. Residents that fail to meet the requirements of the milestones may receive an “unsatisfactory” for six months work or all together fail the class.
Professionalism in Action
Dr. Curry states, “patient-centered care is the basis of all our activities.” This should ring clear to all physicians. Have you put the three pillars of professionalism into place at your practice? Is the entire group practice familiar with them? How do you apply them to your individual practice?
Most physicians understand terms like patient welfare, patient autonomy, patient confidentiality, honesty, and appropriate patient relations. The articles indicates that what takes more effort to improving quality of care is maintaining professional skills through updates, supporting the investigation of new knowledge, social justice, improved access to care, and fair distribution of resources.
Dr. Curry addresses the challenging phrase of “professional responsibility.” Professional responsibility has a spectrum of interpretations that range from maintaining a reasonable fee for service, to not wearing cut-off jeans to work. The less obvious notions of professional responsibility include: promoting your specialty in the political arena, supporting research in your field, and embracing teaching opportunities. The Committee of Ethics recently gave its support to the ASA House of Delegates on the importance of professionalism. Their statements detailed the critical nature of professionalism in anesthesiology. They affirmed the importance of maintaining ethical principles and that professional conduct improves patient safety.
It is not enough to discuss medical professionalism; physicians must intentionally apply the pillars of professionalism to their practice and specialty. Professionalism can help to promote patient safety. Improving patient safety is increasingly important to any healthcare physician, hospital or surgery center as the industry continues to move toward patient-centered payment models.
Excerpted from Professionalism in Anesthesia: A Patient Safety Issue/2014 of the American Society of Anesthesiologists. A copy of the full text can be obtained from ASA, 1061 American Lane, Schaumburg, Illinois 60173.