PROFESSIONALISM
Dr K. Lwere
How to reference this document:
Cruess R., Cruess S., Professionalism. CanMEDS Train-the-Trainer Program on Professionalism. 2009
PROFESSIONALISM
What Is It?
VIGNETTE
Your daughter is scheduled to graduate from Nursery school this
afternoon. As you are preparing to sign out to for the ocassion,
one of your long time patients present in the ER with chest pain.
You enter the ER and a partner in your group practice is already
there to evaluate the situation. As you know that he is competent
and conscientious, you go to reassure your patient. He pleads
with you to stay.
Think about what aspects of professionalism
are demonstrated by this situation
Professional Status is Not an Inherent
Right
IT IS GRANTED BY SOCIETY
It Must Be Constantly Earned by
Meeting the Obligations Expected
of a Professional
PROFESSIONAL STATUS IS
IMPORTANT TO MEDICINE
• IT CONFERS
» Prestige
and Respect
» Trust
» Autonomy
in Practice
» Physician-Led Regulation
» Financial Rewards
PROFESSIONALISM ALSO BENEFITS
SOCIETY
“ Neither economic incentives, nor
technology, nor administrative control has
proved an effective surrogate for the
commitment to integrity evoked in the ideal
of professionalism ”
Sullivan, 1995
PROFESSIONALISM IS THREATENED
•
•
•
•
•
A questioning society
A complex health care system
The commodification of health
Failure of the professions to
meet their obligations
WHAT IS A PROFESSIONAL?
DEFINITIONS-PROFESS(ION)
PROFESS
PROFESSION
PROFESSIONAL
PROFESSIONALISM
A PROFESSION
“A profession…is an occupation that
regulates itself through systematic,
required training and collegial discipline;
that has a base in technical, specialized
knowledge; and that has a service rather
than a profit orientation, enshrined in its
code of ethics…”
Starr
A PROFESSION
 Training is intellectual and involves
knowledge
 Work pursued primarily for others
 Success should be measured by more
than financial return
Justice Louis Brandeis
SEVEN PILLARS OF A PROFESSION
1. Technical skill and
craftsmanship, renewed
by continuing education
2. A sense of social
responsibility
3. A knowledge of history
4. A knowledge of
literature and the arts
5. Personal integrity
6. Faith in the meaning and
value of life
7. The grace of humility
E.P. Scarlett
THE PROFESSIONAL
 Patients first
 Service/public leadership
 Nonjudgmental care
 Collaboration
 Lifelong learning
THE NON-PROFESSIONAL
 Dishonest
 Greedy
 Impaired
 Abuses power
 Lacks
interpersonal
skills
 Conflict of
interest
 Self-serving
PHYSICIANS HAVE TWO ROLES
• Healer
• Professional
• Served simultaneously
• Analyzed separately
Professionalism as the word is used generally
includes both roles
ATTRIBUTES
PHYSICIAN
HEALER
Caring/ compassion
listening
Insight
Openness
Respect for the
healing function
Respect patient
dignity/
autonomy
Presence/Accompany
PROFESSIONAL
L
Competence
Autonomy
Commitment
MD-led regulation
Confidentiality
associations
Altruism
institutions
Trustworthy
Responsibility
to society
Team work
Integrity/Honesty
code of ethics
Morality/Ethical
Behavior
Responsibility to
profession
Based on the Literature
CORE OF PROFESSIONALISM
• Specialized knowledge
Science
Art
• Service to others
• Morality
CONCLUSIONS
I. Time honored characteristics of a
profession
 Specialized education
 Autonomy to set standards
 Commitment to service
CONCLUSIONS
II. Profound changes in the delivery of
health care have introduced real and
significant challenges in regards to
medical professionalism