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EDI
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lORIAL
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Oocup. Mod. Vol. 47, No. 8, p. 449, 1997
Copyright C1997 RapW Science Pubflshora toe SOM
Printed In Great Britain. All rights reserved
0962-748QB7
Reality checks, CME and the pursuit of professionalism
Professionalism is a characteristic to which we all aspire. But it is lifelong learning that is becoming increasingly
acknowledged as but one hallmark of that aspiration. Any occupation that seeks to use the label, profession, will
seek to constantly improve itself in certain distinctive ways.1
The benefits of this Ln-built quality improvement system are obvious. The impact on the care given during the
entire lifetime career of the individual occupational physician is obvious. However, the stature of the speciality to
which we all belong, grows at the same time.
The improvements to which any occupation focuses in its search for professionalization has a common core,
including increased competence in problem solving, a capacity to analyze and assimilate more complex knowledge
and, almost always, a more sensitive awareness and attitude to ethical issues.
Therefore a career of lifelong learning is required to establish, maintain or evaluate the level of accomplishment
suggested by each of these characteristics.
Occupational physicians are not only subject to the impact of medical advances. More often than not, we are
bombarded by new information, thinking, etc. brought about by new legislation, which may have little to do with
scientific or medical reality. As the key professional advisers to industry, we need to cope with this.
The literature expands at a rate of 6-7% compound per year.2 This means a doubling every 10-15 years and a
ten-fold increase throughout the duration of one's career. Society is changing and along with it, its needs and
expectations. Occupational physicians need flexibility to handle these challenges.
It is essential, therefore, that everyone practising occupational medicine not only participates regularly in CME
but in a particular programme or event appropriate for their needs. Methods of delivery need to be sought such
that participation amongst occupational physicians is maximized.
Our concerns about our professional obligations in respect of the quality of care we provide, underpin our
speciality. Accountability for quality is and should be perceived as a professional obligation. It should not be seen
as an answer to the pressures of consumerism, a common currency with our management colleagues, the latest fad
from the management gurus or the most recent idea from process management.3
We cannot overestimate the link between quality and CME. It is not by chance that most, if not all, of the writers
on quality, emphasize at some point, directly or indirectly, the importance of having educated and trained members
of staff. Occasionally, the jargon of empowerment might be used as a synonym. Whether it is Shigeo Shingo's
poka-yoke methods, Taguchi's approach or quality function development, there is a requirement for training,
instruction and regular updating.
Similarly there are common law obligations on employers to provide competent employees. The principle of
ensuring that one's employees keep up to date has been tested in the courts.4
As we all know, in times of hardship and cost cutting, a traditional target is the training budget. How can
occupational physicians avoid the impact of such cost containment measures? Employers certainly need to be made
aware of the implications for them. We can, as a matter of course, ensure that CME which we seek for ourselves
or our staff is relevant to the business needs in a way that meets any rigorous reality checks. Expenditure needs
to be directed towards realization of business benefit, potentially alter practice and justifiable on business grounds.
Those responsible for standards should focus not on relevance, but on the impact of practice. Those responsible
for quality audits need to emphasize explicitly, the need for current expertise.
By recognizing the importance of CME to the quality and the business and recognizing each others' roles and
obligations, CME can avoid becoming just another bureaucratic exercise and instead make a positive contribution
to the health of the working population.
Dr Denis D'Auria
Honorary Editor
REFERENCES
1. Houle CO. Conanumt Learning in tkt Projatiom. San Francisco, CA (USA): Jossey-Bass, 1980.
2. Price DS. The growth of biomedical literature. In: Warren KS, ed. Coping with ths Biomedxcal Lumtun.
3. Hunter JS. Continued learning for the professional. N Z Mtd J 1981; 94: 219-223.
4. Burgesi vi. Thorn Consumer Electronics Ltd [1983]. Tht Tima, 16 May 1983.
New York, NY (USA): Praegar, 1980.
Occiptional
MEDICINE
Occupational Medicine is an international peer-reviewed journal which aims to encourage the critical appraisal and
enhancement of standards of medical practice for the benefit of the workforce. The Journal presents an up-to-date
information service of use to anyone interested in the promotion of health and safety in the workplace. It invites
articles with an international perspective, covering areas such as work-related injury and illness; accident and illness
prevention; health promotion; occupational disease; health education; the establishment and implementation of health
and safety standards; monitoring of the work environment; and the management of recognized hazards. Contributions
are welcomed from practising occupational health physicians and research workers in related fields and should fall
into one of the following categories: Original Paper; Review; Viewpoint; Balance of Opinion; Case Report; Letter
to the Editor or Book Review. Guidance of how to present your paper for potential publication is given in the Notes
for Authors, which are published in this issue or are available from either the Honorary Editor or the Publishers.
Articles to be considered for publication should be sent to the Honorary Editor, Occupational Medicine, c/o The
Society of Occupational Medicine, 6 St Andrew's Place, Regent's Park, London NW1 4LB, UK.
Honorary Editor
D A P D'Auria
Assistant Editors
P J Nicholson,
London, UK
Procter & Gamble, Newcastle upon Tyne, UK
M Sherry, London, UK
D Skan, Belfast, UK
Officers of The Society of Occupational Medicine
President: S A Robson
Immediate Past President: A J M Slovak
President Elect: D O Todd
Hon Secretary: P J J Ryan
Hon Treasurer: N L G McElearney
Hon Meetings Secretary: H M. Guess
Hon Newsletter Editor: D J W Taylor
Communications to The Society of Occupational Medicine should be addressed to:
The Secretary at 6 St Andrew's Place, Regent's Park, London NW1 4LB, UK.
Tel/fax: +44 171 486 2641/0028
Editorial Panel Members
• Tar-Ching Aw
Birmingham, UK
• W B Bunn
Newtown, USA
W Glass
Dunedin, New Zealand
T L Guidotti
Alberta, Canada
A Long
Sydney, Australia
S J Searle
Birmingham, UK
• L Cocchiarella
Edmonton, Canada
L G Holden
Aldershot, UK
K Takahashi
Kitakyushu, Japan
• D Coggon
Southampton, UK
D S D Jones
London, UK
LTWall
Redditch, UK
• J F Caillard
Rouen, France
D Koh
Singapore
N R Williams
Birmingham, UK
• J S Felton
Mendocino, USA
• G Franco
Modena, Italy
P Kxoon
Amsterdam, The Netherlands
R Lauwerys
Brussels, Belgium