Thursday, November 8, 2012

The Tenets of Professionalism

I have often heard the legal profession described as the “second oldest profession” and with the “oldest profession” being an inappropriate topic area for this blog, apparently that would put the medical profession as the “third oldest” profession.  Whether or not either the medical or legal profession can lay claim to precedence to an “older” title is probably irrelevant but the key is both professions have been around for thousands of years; while much has changed, their basis hasn’t.  For the medical profession, this basis is probably best summed up by the famous quote from Dr. Mayo, “The best interest of the patient is the only interest to be considered”.

It may be fairly obvious but by choosing to be trained in one of the medical disciplines, you have “joined” a profession!  Based on the discipline, professionals may voice different oaths, but in the end, we all have committed to several basic behaviors:  confidentiality of the information we have received from those we will serve, clear and effective communication with both the patient and others that will be assisting us in serving the patient, being respectful of those we serve and modeling respect for ourselves and the profession that we represent by our words and actions, and finally actually being available when called upon to take care of our patients or clients.  In the complex world of today’s medicine, in order to meet the “best interests” of the patient, being professional also means that the concept of team needs to be promoted as well.

One of the other major concepts of a profession is that professionals are self-regulating.  This is sometimes thought as merely a personal obligation, but in many instances this can also be peer-to-peer or group obligations.  Essentially, all of us require the skills to provide and receive feedback, especially from our peers, so that the feedback is constructive. 

For the last several years, I have been involved in the Patient Advocacy Reporting System (PARS) created by Vanderbilt University.  The program was developed from research that showed that there was a direct correlation between patient complaints and medical malpractice suits.  The program has been enormously successful because it uses peer messengers to make physicians aware of patient complaints that have been received about them.  Vanderbilt’s research has shown that when physicians receive peer feedback, they are more likely than not (70%+) to act upon the information and bring their focus back to patients and consequently the amount of patient complaints decline (as does the risk of lawsuits).

The success of the PARS program is directly related to professionalism.  The recognition by our peers that the profession is worth self-regulation and that they can play a part by providing feedback about issues that are important to both patients and physicians.  The recognition by the physicians receiving the message and feedback reflects that our peers have a common basis to discuss the feedback with them and that they should take the time to listen to their peers about how to improve their own professionalism.

Being part of a profession is an honored path that we should all recognize and take responsibility for by making the profession better than when we first joined.

--David Danielson, JD, CPA, is Senior Vice President of Clinical Risk Management at Sanford Health, is an Assistant Professor of Internal Medicine at the USD Sanford School of Medicine and is a member of the National Patient Safety Foundation's Board of Governors

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