A recent study revealed that Irish doctors are far less likely to report cases of incompetence or unprofessionalism among colleagues. In fact, only 41% of doctors who had knowledge of such incompetence reported it, compared to 73% in the UK.
The report, Talking About Good Professional Practice,1 which includes surveys of both doctors and patients, also suggests some patients’ trust is misplaced. While 77% of patients believe a doctor would tell them if a mistake had been made, just 63% of doctors completely agreed that they should disclose all significant medical errors.
The report underlines the continuing need to focus on defining and embedding appropriate values throughout doctors’ professional lives; it also highlights the need to build a workplace setting which enables doctors to put professional values into action. Collaboration with partners, including the Department of Health, HSE, independent hospitals, and postgraduate medical training bodies will be important to achieve this aim.
Minister of State for Primary Care Alex White said he would “encourage doctors not to be reticent” when they had knowledge of unprofessionalism. “It may be a culture has grown over the years where you don’t speak out and you don’t bring forward issues and gradually we have to change that, but it can’t be done by a simple edict.”2
What is professionalism?
The concept of professionalism is the basis of medicine’s contract with society. It’s what society and patients expect of their healthcare professionals. Professionalism is the way that healthcare professionals fulfil their part of this contract and in return they are rewarded by the trust of patients.
How do you personify professionalism? Some people would see professionalism as being predominantly about observable behaviours. Others believe it is a much broader concept encompassing competences in terms of knowledge, clinical and non-clinical skills, which together with appropriate attitudes and values result in expected professional behaviours and relationships.
The concept of professionalism is the basis of medicine’s contract with society
When it comes to day-to-day practice, professionalism is about adherence to a defined set of standards. You should work with your trainee to try and incorporate these standards and codes of practice into everyday behaviour and performance by following the Medical Council’s guidance, Guide to Professional Conduct and Ethics for Registered Medical Practitioners.3
A patient’s trust in a doctor is no longer assumed; it is reached and earned through a display of appropriate professional qualities and behaviours, for example, expertise, probity and concern or caring, and these act as markers of professionalism.
Communication issues and poor doctor–patient relationships are major causes of medicolegal action and complaints
Communication issues and poor doctor–patient relationships are major causes of medicolegal action and complaints.4 Many of these communication behaviours would be viewed as unprofessional: poor communication (not being listened to, lack of empathy, lack of information), disempowerment (feeling devalued, not being understood or taken seriously), desertion (feeling abandoned, family excluded, staff arrogance).5