Rana Al-Senawi, MBBS

Sultan Qaboos University Hospital

Muscat, Oman

Professionalism in Medical Practice

Outline

• Definition • Elements• Medical Professionalism Charter

Definition

• Profession from Latin word

“professio” = public declaration with the force of promise.

Professionalism

“You are in this profession as a calling, not as abusiness; as a calling which exacts from you atevery turn self-sacrifice, devotion, love andtenderness to your fellow-men. Once you getdown to purely business level, your influence isgone and the true light of your life is dimmed.You must work in the missionary spirit, with abreadth of charity that raises you far above thepetty jealousies of life.”

Osler 1907

Professionals

• Disciplined group of individuals adhere to high ethical standards and uphold themselves to, and are accepted by, the public as possessing special knowledge and skills in a widely recognised, organised body of learning derived from education and training at a high level, and who are prepared to exercise this knowledge and these skills in the interest of others. 

• Inherent in this definition is the concept that the

responsibility for the welfare, health and safety of the community shall take precedence over other considerations.

Elements

• Altruism• Accountability• Excellence• Honesty/ Integrity• Duty• Respect and compassion to patients• Responsiveness to the needs of patients• Sensitivity to cultural, ethical, religious or other

values of patients• Empathy in negotiating and designing treatment• Confidentiality and privacy for all patients

Altruism

Self

• Put others (learner/patient) before self

• Strive for the “Greater Good”

Patient interaction• Identify patient needs and interests even when

patient is reticent to provide• Resolve conflicts in favor of patients needs• Bo open to alternatives that will provide excellent

patient care while meeting patient needs• Advocate for patient in all settings

Accountability

Self Take responsibility• for achievement of ultimate goal• of actions and outcomes and admit to and accept those

outcomes• Accept role if learners fail• Acknowledges lapses errors as teacher/learner without

blaming

Patient interaction • Follow through on tasks and promises in patient care• Acknowledge mistakes/ lapses to others including

disclosure to patient

Excellence

Self • Be knowledgeable• Continues to improve self• Demonstrates curiosity• High personal standards

Patient interaction • Provide best available patient care possible• Exceed patient expectations for care and

interpersonal interactions

Honesty/ Integrity

Self • Be truthful and honest with self• Be an example to the people around you• Recognizes and acknowledge own skills, abilities,

limitations and weaknesses• Adhere to values in all actions• Follow through on assigned tasks and

responsibilities

Patient interaction • Be honest and truthful with patients• Follow through with promises too patients and

explain when unable to do so• Give the care you would want to receive

Duty Self : Meeting responsibilities• Fulfill roles• Assure compliance programmatic regulations• Supervise• Follow through on all tasks• Accept obligations and roles• Give best effort to every learner and patient• Maintain balance in life to allow achievement of personal

and professional goals

Patient interaction • Balance need for education with responsibility to patient• Be available and accessible• Recognize need to ensure patient safety• Complete task at hand well while being responsive to theenvironment• Prioritize tasks of patient care and teaching

Respect

Self : Consideration of Others• Arrival on time• Consider effects your actions have on all participating

parties• Acknowledge others needs & feelings• Acknowledge input of others with different experiences• Don’t denigrate other’s work, approach, style, culture• Seek to understand differences and utilize

commonalities to optimize outcomes

Patient interaction • Identify & align patient values with educational/ patient

carevalues & goals• Recognize that all patients are worthy of courtesy and

excellence in care• Be kind and fair to all without judgment

ABIM FoundationACP FoundationEuropean Federation of Internal Medicine

Fundamental principles

1. Primacy of patient welfare

2. Patient autonomy

3. Social justice

Set of professional responsibilities

• professional competence • honesty with pts• pt confidentiality • maintaining appropriate relations • improving quality of care • improving access • a just distribution of finite resources • scientific knowledge • maintaining trust by managing conflicts of

interest • professional responsibilities