The concept and challenges of medical professionalism
الموضوعات : Report of Health CareMarzieh Lashkari 1 , Amin Beigzadeh 2
1 - MSc of Health Services Management, Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
2 - PhD Candidate of Medical Education, Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
الکلمات المفتاحية: Challenges, Professionalism, Concept,
ملخص المقالة :
We argue that the field of medicine ought to think over the definition of medical professionalism and the challenges that doctors face in everyday practice. Although there are a diversity of definitions revolving around medical professionalism, but the most recent and revalidated definition should be taken into account. In addition, we highlight four barriers threatening professionalism: 1) doctors’ of self-interest; 2) doctors’ temptation to deviate from the standards of medicine; 3) market incentives (financial conflicts of interest); and 4) peer pressures. We conclude with suggestions for remedies to overcome these threats, e.g. selection criteria of medical students, and stringent rules and guidelines.
1. Rowley BD, Baldwin DC Jr, Bay RC, Cannula M. Can professional values be taught? a look at residency training. Clin Orthop Relat Res 2000; (378): 110-4.
2. Van De Camp K, Vernooij-Dassen MJ, Grol RP, Bottema BJ. How to conceptualize professionalism: a qualitative study. Med Teach 2004; 26(8): 696-702.
3. Wearn A, Wilson H, Hawken SJ, Child S, Mitchell CJ. In search of professionalism: implications for medical education. N Z Med J 2010; 123(1314): 123–32.
4. Patel P, Robinson BS, Novicoff WM, Dunnington GL, Brenner MJ, Saleh KJ. The disruptive orthopaedic surgeon: implications for patient safety and malpractice liability. J Bone Joint Surg Am 2011; 93(21): e1261-6.
5. Salam A, Rabeya Y. Residential field site training: Bangladesh approach to community-based education to develop generic skills in tomorrows’ doctors. Middle East Journal of Nursing 2009; 3(5); 22-7.
6. Accreditation Council for Graduate Medical Education. General competencies [internet]. Chicago: ACGME; 1999. Available from: https://www.acgme.org/acgmeweb/; accessed January 5, 2015.
7. American Board of Internal Medicine Foundation, American College of Physicians-American Society of Internal Medicine Foundation, European Federation of Internal Medicine. Medical professionalism in the new millennium: a physician charter. Ann Intern Med 2002; 136(3): 243-246.
8. Lee AG, Beaver HA, Boldt HC, Olson R, Oetting TA, Abramoff M, et al. Teaching and assessing professionalism in ophthalmology residency training programs. Surv Ophthalmol 2007; 52(3): 300-14.
9. Dana J, Loewenstein G. A social science perspective on gifts to physicians from industry. JAMA 2003; 290(2): 252-5.
10. Cohen JJ. Professionalism in medical education, an American perspective: from evidence to accountability. Med Educ 2006; 40(7): 607-17.
11. Schafer A. Biomedical conflicts of interest: a defense of the sequestration thesis-learning from the cases of Nancy Oliveri and David Healy. J Med Ethics 2004; 30(1): 8-24.
12. Johnson C. Bad blood: doctor-nurse behavior problems impact patient care. Physician Exec 2009; 35(6): 6-11.
13. Cleland J, Dowell J, McLachlan J, Nicholson S, Patterson F. Identifying best practice in the selection of medical students. London, United Kingdom: General Medical Council; 2013.