Profesionalism and Managerial

Skill
 Profesionalism Dimensions
• adherence to ethical practice
• effective interactions with patients and service
users and staff
• reliability, and commitment to improvement
which illustrate the behavioural focus of many
of these approaches
• Medical professionalism signifies a set of
values, behaviours, and relationships that
underpins the trust the public has in doctors.
• The professional is the person who is able to
put into practice what the professional values
are. Sir Kenneth Calman (6 May 2005)
• Medicine is a vocation in which a doctor’s
knowledge, clinical skills, and judgement are
put in the service of protecting and restoring
human well-being. This purpose is realised
through a partnership between patient and
doctor, one based on mutual respect,
individual responsibility, and appropriate
accountability.
• Professional behaviours are seen to be the
expression of professional attitudes – and
significant work in medical professionalism
• The relationship between doctors and society, the
doctor–patient relationship, and the
environments in which doctors undertake their
training and their practice, have all changed.
• The trust that patients have in their doctor is
critical to their successful care.
• Medicine bridges the gap between science
and society
• the application of scientific knowledge to
human health is a crucial aspect of clinical
practice
• Doctors are one important agent through
which that scientific understanding is
expressed
• But medicine is more than the sum of our
knowledge about disease.
• Medicine concerns the experiences, feelings,
and interpretations of human beings in often
extraordinary moments of fear, anxiety, and
doubt. In this extremely vulnerable position, it
is medical professionalism that underpins the
trust the public has in doctors.
• professionalism will inevitably lead to better
health outcomes, patients certainly
understand the meaning of poor
professionalism and associate it with poor
medical care
• The public is well aware that an absence of
professionalism is harmful to their interests
• medical professionalism as a set of values,
behaviours, and relationships that underpin
the trust the public has in doctors
 Implications
• leadership,
• teams,
• education,
• appraisal,
• careers, and
• research
• Professionalism therefore implies multiple
commitments – to the patient, to fellow
professionals, and to the institution or system
within which healthcare is provided, to the
extent that the system supports patients
collectively.
• Medicine’s ability to alleviate suffering,
prevent disease, and treat illness has never
been greater than it is today. Yet that success
has not always been guaranteed. It has been
and remains founded upon a covenant
between the medical profession and society.
• No drug is entirely free of potential adverse
effects. Every surgical procedure carries with it
the chance of a complication. Science has
justifiably raised the expectations of the public
about what medicine can offer. But doctors now
have a parallel challenge to embed these
expectations in a realistic appraisal of what can
and cannot be achieved by medical science.
Doctors have the difficult task of explaining the
nature of uncertainty and risk in the practice of
today’s scientific medicine.
 Research result
• They had to do more to put patient interests
at the heart of their practice. They had to
define a new ‘compact’ between themselves,
government, the public, health-service
managers, and patient groups. They had to
strengthen medical leadership. And they had
to define more clearly the roles of doctors and
managers.
 In their day-to-day practice, doctors
are committed to:

• integrity
• compassion
• altruism
• continuous improvement
• excellence
• working in partnership with members of the
wider healthcare team.
Trust – and so professionalism – operates at two
levels:
• in the doctor providing care (individual
professionalism)
• in the system where that care is given
(institutional professionalism)