Profesionalism and Managerial Skill

Profesionalism Dimensions adherence to ethical practice effective interactions with patients and service users effective interactions with staff reliability, and commitment to improvement which illustrate the behavioural focus of many of these approaches

Medical professionalism signifies a set of values, behaviours, and relationships that underpins the trust the public has in doctors. The professional is the person who is able to put into practice what the professional values are. Sir Kenneth Calman (6 May 2005)

Medicine is a vocation in which a doctor’s knowledge, clinical skills, and judgement are put in the service of protecting and restoring human well-being. This purpose is realised through a partnership between patient and doctor, one based on mutual respect, individual responsibility, and appropriate accountability.

Professional behaviours are seen to be the expression of professional attitudes – and significant work in medical professionalism The relationship between doctors and society, the doctor–patient relationship, and the environments in which doctors undertake their training and their practice, have all changed. The trust that patients have in their doctor is critical to their successful care.

Medicine bridges the gap between science and society the application of scientific knowledge to human health is a crucial aspect of clinical practice Doctors are one important agent through which that scientific understanding is expressed

But medicine is more than the sum of our knowledge about disease. Medicine concerns the experiences, feelings, and interpretations of human beings in often extraordinary moments of fear, anxiety, and doubt. In this extremely vulnerable position, it is medical professionalism that underpins the trust the public has in doctors.

professionalism will inevitably lead to better health outcomes, patients certainly understand the meaning of poor professionalism and associate it with poor medical care The public is well aware that an absence of professionalism is harmful to their interests

medical professionalism as a set of values, behaviours, and relationships that underpin the trust the public has in doctors

Implications leadership, teams, education, appraisal, careers, and research

Professionalism therefore implies multiple commitments – to the patient, to fellow professionals, and to the institution or system within which healthcare is provided, to the extent that the system supports patients collectively.

Medicine’s ability to alleviate suffering, prevent disease, and treat illness has never been greater than it is today. Yet that success has not always been guaranteed. It has been and remains founded upon a covenant between the medical profession and society.

No drug is entirely free of potential adverse effects No drug is entirely free of potential adverse effects. Every surgical procedure carries with it the chance of a complication. Science has justifiably raised the expectations of the public about what medicine can offer. But doctors now have a parallel challenge to embed these expectations in a realistic appraisal of what can and cannot be achieved by medical science. Doctors have the difficult task of explaining the nature of uncertainty and risk in the practice of today’s scientific medicine.

Research result They had to do more to put patient interests at the heart of their practice. They had to define a new ‘compact’ between themselves, government, the public, health-service managers, and patient groups. They had to strengthen medical leadership. And they had to define more clearly the roles of doctors and managers.

In their day-to-day practice, doctors are committed to: • integrity • compassion • altruism • continuous improvement • excellence • working in partnership with members of the wider healthcare team.

Trust – and so professionalism – operates at two levels: • in the doctor providing care (individual professionalism) • in the system where that care is given (institutional professionalism)