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LEARNING OBJECTIVES

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  1. To convey the pitfalls of assuming professionalism is a character trait.

  2. To articulate the advantages of viewing professionalism as a multifaceted competency.

  3. To explain the connection between personal wellbeing and professional resiliency.

  4. To describe skills set needed to maintain professionalism in stressful circumstances.

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INTRODUCTION

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Joan kicked off her shoes and sank into her chair. It had been such a bad day. She has been on a clinical rotation for only a week and already she is thinking that she won't be able to be a good doctor. It's not taking the history or doing the physical examinations or even fielding the rapid-fire questions on rounds. It's the professionalism issues that worry her. Almost every day this week she has seen doctors and nurses lose their tempers with one another— responding sarcastically, leaving in anger, and yelling at the team for a bad outcome that wasn't their fault. Even worse, today, she found herself getting really angry at a patient who just refused to talk with her and then complained about her on rounds. She actually went back after rounds to tell him off, but fortunately his granddaughter was in the room, which made her think twice. She came into medical school to be a caring and compassionate physician and thought that the professionalism stuff would be easy—you know, just follow the golden rule and you will be fine. She realizes now that all of those professionalism lectures in the first 2 years were there for a reason—to drill into her head the need to work to ensure that she is the doctor her patients need her to be. But she had no idea it would be so hard— just reminding people to be professional doesn't seem to be enough. How do the best doctors do it?

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Professionalism is at the heart of all that we as physicians aspire to be. When we enter medical school, we imagine ourselves calmly and compassionately ministering to the suffering by selflessly using our carefully honed skills and knowledge to determine and carry out the best treatment plan possible for the patient in front of us. In return, we would be appreciated and feel gratification.

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In today's environment, professionalism appears to be under threat. On the national level, reports of unprofessional physician behavior—ranging from overt crimes, to abuse of power, to conflicts of interest—are easily disseminated using today's web-based communication tools. Each sensational story raises questions about why such a person was allowed into the medical profession and why the profession itself hasn't fulfilled its obligation to oversee its members and deal with the rogue physicians who are the subject of national headlines. At the state level, medical boards receiving complaints about physicians have few options other than to sanction with license suspension or revocation and publicize the names of the transgressors. At the institutional level, hospitals are struggling with physicians who exhibit ...

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