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Professionalism

What is professionalism? The term is often used, but hard to define. One definition: "...the means by which individual doctors fulfill the medical profession's contract with society. The specific attributes that have long been understood to animate professionalism include altruism, respect, honesty, integrity, dutifulness, honour, excellence and accountability."

There is a way to explain it in relation to consequences that everyone can understand. Many of you will suffer at least a million dollars in lost income over the course of your careers as a result of poor professional behavior by colleagues. The obvious reason is malpractice costs. Since less than 5% of physicians account for most of the malpractice cases, the cost for insurance will increase for the other 95%.

There is an even greater loss, probably at least three times the overall loss through malpractice, as a consequence of medical fraud and abuse that drains resources away from those who are trying to do their best for patients (and drawing health care resources away from those who really need it). The good physician considers "What's in it for the patient?" more than "What's in it for me?"

At least 10% of the resources in staffing of any organization are expended dealing with behavioral problems of persons employed by that organization. That 10% could have been used to see more patients, do more procedures, or have more time off. In a competitive economy, behavioral problems, from physicians down through all ranks of health care workers, drive away business. Many patients do have a choice, and will exercise that option.

A third of medical malpractice lawsuits are generated from within the health care system. Persons who have been treated badly by colleagues are more than willing to point out shortcomings of those colleagues to patients. Whistleblowers get a financial reward in cases of fraud.

How does professionalism play a role in all of these consequences? Just work backward from the poor outcomes and ask, "Why did that happen? What should have been done? What should have been avoided?" Many of those "should's" and "should not's" begin in medical training.

References:

Cohen JJ. Professionalism in medical education, an American perspective: from evidence to accountability. Med Educ. 2006;40:607-17.

Office of the National Coordinator for Health Information Technology (ONC). Health Information Technology and Health Care Anti-Fraud. United States Department of Health and Human Services. http://www.hhs.gov/healthit/hithca.html (Accessed July 8, 2010)


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