HLT 307 Week 1 Discussion Question Two

HLT 307 Week 1 Discussion Question Two

The following is an excerpt from the textbook reading Professionalism in Health Care:

“If you want to be viewed as a health care professional, you need to be aware of what’s going on in your industry… you need to be keep up with current trends and issues and consider how they might affect your job, your patients, your personal health, and your career.” (Makely, et. al, p. 5)

Give three reasons why it is important for health care professionals to be knowledgeable about what is happening in the health care industry. Provide at least two examples from your readings of ways to keep up with current trends and issues.

In this issue, the members of the Committee on Professionalism of the Canadian Association of General Surgeons have undertaken to define a new position paper on professionalism for the general surgeon.1 As stated by the Committee, it is essential to raise the awareness of professionalism in surgery, to define its importance and to be very aware of what constitutes unprofessional behaviour. It is hoped that this document will serve as a ready reference for students and residents — an appropriate objective, considering the aggressive expansion of education programs that are taking new learners into multiple communities distributed throughout the country. As part of this initiative, it is essential to reflect on the rights and responsibilities of learners and surgeons alike and also to reflect on processes that exist to support concerns that arise.

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Why is professionalism so important? The primary rationale for professionalism and collaboration is to promote patient safety. Health care is delivered by teams of professionals who need to communicate well, respecting the principles of honesty, respect for others, confidentiality and responsibility for their actions. Further, the working environment in health care comprises multiple learners, among them fellow physicians, residents and nonphysicians, including students and patients.

How well are physicians doing in terms of professional behaviour? A good way to enquire about this behaviour is to conduct surveys of one’s own undergraduate trainees. These trainees have the opportunity to observe perverse interactions such as belittlement or humiliation, threats of physical harm or discrimination arising from sexual, racial and sexual orientation sources. Recent surveys of graduating classes in our own and other schools show that these types of behaviour are observed in the health care environment and include behaviours arising from clinical faculty, nurses, residents and patients themselves. The surprising observation is that the leading numbers of perceived concerns arise from clinical faculty themselves (not necessarily surgeons!). Some forms of unprofessional behaviour may be subtle, such as instances of unintended disrespect for the judgments of peers, breaches of confidentiality and dishonesty in the disclosure of adverse events. A prime example is the electronic mail communication that criticizes another’s actions and often invites a chain of equally unprofessional responses — a practice that has likely received stern warnings from medical advisory committees in many hospitals!

What are the rights and responsibilities of learners and surgeons? Learners have the right to be challenged to learn with freedom from abuse, harassment or humiliation. They also have the right to fair, respectful and objective evaluations. At the same time, learners have the responsibility to behave as professionally as their instructors. Faculty surgeons have an essential responsibility to model professional behaviour. They should challenge trainees without abuse and humiliation and respect personal boundaries. As role models, it is essential that faculty surgeons avoid discrediting the reputation of peers and other health professionals. An example of such negative role modelling is the highly critical rounds that disparage care provided at “St. Elsewhere,” particularly when all the local factors that lead to decisions at another site are unknown. These types of interactions need to be identified and resisted by experienced opinion leaders in our departments.