PROFESSIONALISM

Definition

A set of values, behaviors, and relationships that underpins the trust the
public has in doctors. ”Professionalism in today's world is a mark of excellence
for doctors. When a doctor becomes aware of the fact that the people have
certain expectations and they have certain standards for judging the
competence of doctors the sense of responsibility increases and improves the
patient care. Professionalism has to do a lot with effective communication
skills, achieving excellence in skills plus ethics. Professionalism is also the
moral understanding among medical practitioners that gives reality to what is
commonly referred to as the social convention between medicine and society.

Professionalism is habitual and judicious use of communication,

knowledge, technical skills, clinical reasoning, emotions, values and reflection
in daily practice for the benefit of the individual and community.

Professional competence that should be practice spontaneously

regarding upgrading your knowledge, improving your skills, better
communication, showing your commitments and sympathy, giving good
explanation to your judgment armed with values in all aspects that at the end of
the day ensure safe patient with full satisfaction for all parties looking after the
patient.
Medical professionalism was defined by many organizations such as
The American College of Physicians, The European Federation of Internal
Medicine, American College of Surgeons, American Medical Association
(AMA), Association of American Medical Colleges, as, “an impressive
catalogue of virtues in an era when physician autonomy and self-regulation are
increasingly challenged by third-party payers, patients and their families, and
external critics. Physicians are expected, among other things, to subordinate
their own interests to the interests of patient (and to assume risk when doing
so); to strive for excellence, knowledge, and competence; to work for fair
allocation of health care resources; to treat patients, physician colleagues, and
other health care professionals with respect; to avoid conflicts of interest; and
to demonstrate sensitivity to other cultures".

Principles of Professionalism

Principles are built upon the establishment of clinical competence,

communication skills and ethical and legal understanding. To show
professionalism you must be:
Competent in your field, Good communication skills, and Ethical oriented

The American Board of Internal Medicine (ABIM), who is leader and

has explicitly, addressed the definition of professionalism in the 1990s, Their
widely adopted definition was broad and inclusive, composed of three
commitments and six elements:
The three commitments are:

To maintain the highest standards of excellence in the practice of medicine

To sustain the interests and welfare of patients

To be responsive to the health needs of society.

The six elements of professionalism as defined by the ABIM include:

Altruism, accountability, excellence, honors, integrity, and respect for others.

Pillars of professionalism

Probity

The word “probity” is taken from the Latin for good, honest and upright.
A professional person should be all these things, as well as fair, law-abiding
and of general good character. Probity is central to the public trust placed in the
medical profession and a professional person should, through their actions,
uphold this reputation.

Altruism:
1. Pursue to serve patients and their families with perfect clinical care, with
their needs first
2. Assists colleagues/ learners to address personal issues and enhance
knowledge and skills required in a clinical or educational setting
3. Actively supports the educational mission
4. Recognizes that the time and energy specified to performing these
functions should not interfere with time for caring for self and family.

Honesty and Integrity

5. One must uphold the highest standards of behavior and refrain from words
and actions that would violate one’s personal or professional
codes.
6. In learning and study, demonstrating honesty and trustworthiness by
referencing sources for intellectual material.
7. Openly identifies personal conflicts that interfere with patient's care.
8. The patient can easily understand the provided information and respects
patients' confidentiality
Respect:

There are expectations that a professional will work and behave in a

manner that is appropriate to the nature of their particular profession. In
medicine, these expectations are unique: good standards of personal appearance
and dress, appropriate standards of speech and personal conduct – such
attributes will confirm to a patient an acceptable standard of respectability

Is good-natured in daily interactions with classmates, teacher's health

care professionals, patients, and families? To respect others is to hold and
acknowledge in high regard feelings, opinions, and values of the members of
the larger medical community whether at school, or in clinical environments.
This should apply to individual patients and their families, other health care
professionals, colleagues, coworkers, and others with whom they come in
contact. One must respect the dignity and autonomy of individual patients, take
their beliefs and values into consideration, and maintain their confidentiality at
all times.

Responsibility and Accountability

Responsibility focuses on what one can do and should do; it defines the
duty and moral obligation and responsibilities to individual patients, to health
care professionals, to society, and to the profession.
Accountability is often used interchangeably with responsibility, yet the
terms are different. Accountability measures one’s behavior against established
rules or norms. Placing emphasis on accountability risks that too much
attention may be focused on the rules, with both agent and overseer losing sight
of what is ultimately important. By contrast, responsibility implies duty and
moral obligation. Hence, the responsibility relationship is one of trust.
We should encourage the doctor responsibilities required to sustain
professionalism which could be summarized as follows :

1. Maintain professional competence and be committed to evaluating and

upgrading scientific knowledge
2. Seeks clarity on roles and responsibilities and managing conflicts of interest
from colleagues, teachers, staff and preceptors.
3. Attends to own personal health through nutrition and physical activity and
seeks help when physically or mentally ill
4. Commits to excellence in health care, improving access to care, and
optimizing the health of the community
5. Seeks and gives feedback to colleagues, teachers, staff and preceptors.
6. Be honest with patients
7. Respect patient confidentiality
8. Avoid inappropriate relations with patients
9. Advance scientific knowledge
10. Improve quality and access of care
11. Promote the just distribution of resources

Standards

A professional person is expected to have the ability and dedication to

achieving a set of standards in their duties that their peers find acceptable

Expertise
A professional person is expected to have a particular set of skills in their
chosen field, at a level that can be considered expert. This will have been
acquired through learning, knowledge, training and practice of the relevant
skills and, in most cases, this can be demonstrated by qualifications or
accreditation of some kind. The validity of this expertise is maintained by
ongoing training throughout the course of a medical career.

Commitment to Excellence
Excellence is a conscientious effort to exceed ordinary expectations. It
implies first a commitment to lifelong learning. Besides, to continually
inundated with new knowledge that requires a commitment to continued
learning: new studies are published that have a direct impact on patient care;
practice guidelines are revised and updated; new drugs emerge, and the
efficacy and safety of existing drugs are regularly challenged; advances in
technology change the way health care is delivered; and new legislation and
policies have implications on the practice.

Care and Compassion

To care and to be compassionate are at the very center of the fiducial
relationship with the patient. Caring, in the most basic terms, means to attend to
the needs of others and to have personal concern for the well-being of another.
Caring, in the professional context, has been defined as expressing attitudes
and actions of concern for patients to support their well-being, alleviate undue
discomfort, and meet obvious or anticipated needs. To be compassionate is to
recognize and understand the needs of others but, more important, to act on this
compassion and desire to help them.

Role of Students

Regarding role of student in professionalism, it is to develop personal

behaviors consistent with a respect for chosen profession. Students need to
commit to responsibilities as:
1. Seek and accept feedback and constructive instruction from teachers, peers,
residents and faculty in order to continually improve educational
experience, knowledge, and clinical skills.
2. Commit to the highest standards of competence
3. Be mindful of demeanor, language, and appearance in the classroom, in the
presence of patients, and in all health care settings.
4. Admit to and assume responsibility for mistakes in a mature and honest
manner and develop productive strategies for correcting them.
5. Refrain from using illicit substances. Refrain from using alcohol, non-
prescription or prescription drugs in a manner that may compromise
judgment or ability to contribute to safe and effective learning.
6. Be considerate and respectful of others’ (teachers, peers, residents and
faculty) time, rights, values, religious, ethnic and socioeconomic
backgrounds, lifestyles, opinions, and choices
7. Meet the expectations for participation and timeliness that are
communicated to me by those who teach me.
8. Recognize limitations and seek help when one’s expertise, knowledge, or
level of experience is inadequate to handle a situation in the classroom,
hospital, or research setting.