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LEARNING OBJECTIVES

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  1. To explain how healthcare organizations influence professionalism.

  2. To identify common themes in organizations that have successfully advanced professionalism in their institutions.

  3. To identify the organizational “levers” for influencing professionalism.

  4. To provide illustrative examples of how several specific organizations have advanced professionalism.

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INTRODUCTION

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The framework for professionalism described in this book includes consideration of the role of organizations in building a culture of professionalism. Our premise is that systems in which physicians practice influence physicians' behaviors in positive or negative ways by shaping the practice environment. The chapters on patient-centered care, integrity and accountability, pursuit of excellence, and fair and ethical use of healthcare resources each included a section on the role of the healthcare system in contributing to professionalism. This chapter describes further the role of the healthcare system, including academic medical centers, ambulatory care centers, community hospitals, and integrated delivery systems, and provides some specific examples of organizations that have integrated some aspect of professionalism into their culture.

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Egener and colleagues (2012) propose that healthcare organizations, particularly nonprofit ones, have a responsibility to uphold the values of professionalism because these organizations are perceived as the face of the profession by the public and because their tax exempt status requires them to serve the best interest of the public. We suggest that healthcare organizations should uphold the ethical values of beneficence, dignity, justice, honesty, and self-discipline, just as individual healthcare professionals should do. In order to live up to these values, they suggest that organizations need to develop competencies and demonstrate professionalism behaviors. For example, the value of beneficence means doing good and acting with generosity. For an organization, this may mean providing services not only to patients who come to the facility, but also proactively providing care for patients in the community who may not come in but need help to be healthy or to manage medical problems. Other organizational behaviors that demonstrate a commitment to this value could include caring for uninsured patients in the community or working to eliminate health risks in the community (e.g., environmental hazards, gun violence, and obesity). In other words, healthcare organizations can demonstrate professionalism by committing to a set of ethical values and acting to realize them. Table 12-1 presents a set of values, competencies, and behaviors to describe organizational professionalism. Organizations also set the internal culture that shapes the work of the physicians, nurses, and other members of the team. Healthcare organizations provide a powerful message about “how things are done around here” through formal policies and procedures, incentives, and informal and usually unwritten rules that are modeled by leaders.

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Table Graphic Jump Location
Table 12-1ORGANIZATIONAL VALUES, PROFESSIONALISM COMPETENCIES, AND BEHAVIORS

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