Professionalism In The
Practice Of Medicine
Where Are We Now?
Ora Paltiel, MDCM, MSc, FRCPC
Dead Sea, December 2016
Let’s start with definitions…
Professionalism
noun pro·fes·sion·al·ism \prə-ˈfesh-nə-li-zəm:ˈ
the skill, good judgment, and polite behavior that is expected from a
person who is trained to do a job well
Source: Merriam-Webster's Learner's Dictionary
• Professionalism is the basis of medicine's contract with society.
It demands placing the interests of patients above those of the physician,
setting and maintaining standards of competence and integrity, and providing
expert advice to society on matters of health.
Sox, Ann Int Med 5 February 2002
Professionalism- Universal values?
Illinois Law School
Medical Professionalism
What is it?
• ABMS search found 20 definitions
• Lists of principles
• Lists of attributes
• List of behaviors
Wynia Acad Med. 2014;89:712–714.
"Treating illness is why we became
doctors. Treating patients is actually what
makes most doctors miserable."
Professionalism- ABMS
Has to do with expectations
Medical professionalism is a belief
system about how best to organize and
deliver health care, which calls on group
members to jointly declare (“profess”)
what the public and individual patients
can expect regarding shared competency
standards and ethical values and to
implement trustworthy means to ensure
that all medical professionals live up to
these promises.
High Levels of Public Satisfaction in
Primary Care in Israel
2007 Survey:
• 63% waited for less than 15 minutes before seeing
family doctor;2/3 seen on same day
• 93% "satisfied" or "very satisfied" with the interpersonal
skills and behavior of the doctor
2015 Survey:
Public Opinion (of Aged 20 and Over) on Health Services
Of those who visited family doctor in the past year:
94% satisfied with attitude of family doctor
90% satisfied with clinic location
83% satisfied with office hours
Expectations
My hand in the blender
Patient satisfaction survey – Emergency Rooms Israel 2015 2015
Doctors were
affable & respectful
Related to pain
Staff introduced
themselves
Would we want to be treated where we
work?
Aiken, et al BMJ 2012; 344 (Published 20 March 2012)
Reasons for
licensing
suspension
in Israel
K.T. Li Professor of International Health
Director, Harvard Global Health Institute
Department of Health Policy and Management
The three A's of success
• "Availability, affability, and ability are
what young M.D.s need to build a
practice “
• attributed to famed physician and
teacher Sir William Osler. "And, in that
order of importance."
Is it doable?
Primacy of
patient’s
welfare
Challenges to Professionalism
Who is the patient?
Who has the time?
Cultural issues
Hierarchy vs informality
Training for professionalism?
From a med-student blog
How to prevent burnout?
How to maintain the sense of awe
and privilege?
What we hope to accomplish in this workshop
• Examine models and systems that have taken on the challenge of
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professionalism
Examine professionalism as a learned competence
Examine complaints as a tool to improve professionalism
Examine models of regulating professional behavior
Explore generational issues and professionalism in the digital age
Search for answers, solutions and strategies and not just questions
Our guests
BMA
Our participants
• Family Medicine
• Internal Medicine
• Geriatrics, Hematology, Endocrinology
• Pediatrics
• Ob-Gyn
• Surgery
• Otolaryngology
• Neurology
• Psychiatry
• Radiology
• Pathology
• Medical Administration
• Nursing
• Social Work
• Psychology
• Biostatistics
• Bar Ilan, Technion, Tel Aviv,
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Hebrew-University-Hadassah,
Ben-Gurion Schools of Medicine
Harvard, UCL, University of
Toronto, Durham University
Clalit, Maccabi, Meuhedet, Leumit
Health Services
Poria, Carmel, Rambam, TASouraski, Barzilai, Hadassah Ein
Karem, Hadassah Mt. Scopus,
Shaare Tzedek, Soroka Hospitals
MOH, BMA, National Insurance
Institute,
NIHPR