Re: Professionalism in Medicine: An A-Z Primer
From: art fougner, md (evsono@pipeline.com)
Wed Jul 3 09:12:39 2002
i would add under G - guts! a commodity somewhat lacking in the leaders
of our so-called professional societies.
i also would consider removing the letters P & C - because more harm has
been done in the name of political correctness.
just my opinion - i could be wrong.
art
At Wed, 3 Jul 2002, Efrain Ramirez wrote:
>
>There are some one can add--eg "L" - legal minded?
>
>Current Commentary
>June 2002
>Volume 99, Number 6
>Pages 1127 - 1128
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>Professionalism in Medicine: An A-Z Primer
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>Patrick Duff, MD,a
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>To be successful as physicians, we should adhere to a simple,
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>time-honored code of conduct. We must commit ourselves to a lifetime of
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>self-directed learning. We must strive to be thoughtful, kind, and
>sensitive. We must avoid arrogance, dogmatism, and negativism. We must
>be honest, moral, tolerant, trustworthy, and above all else, humble and
>compassionate. Consistent adherence to these traits will help us
>maintain the nobility and credibility of the medical profession.
>
>aUniversity of Florida, College of Medicine, Department of Obstetrics
>and Gynecology, Division of Maternal-Fetal Medicine, Gainesville,
>Florida, USA
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>(Obstet Gynecol 2002:99:1127-1128. © 2002 by The American College of
>Obstetricians and Gynecologists.)
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>I have practiced medicine for 27 years, first as a resident and fellow,
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>then as a student clerkship director, division chief, residency
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>director, and finally an associate dean of students. In my experience,
>I have observed that very few physicians falter because of a lack of
>intellect or a major deficit in technical skills. Rather, the few that
>are not successful in their practice have difficulty because of poor
>professional behavior. Medicine demands an exceptionally high standard
>of professionalism, and this high standard can be achieved by virtually
>all of us if we simply remember that, to be good physicians, we first
>must be good people. I offer the following A-Z primer as a reminder of
>the simple rules of good behavior in medical practice.
>
>A is for arrogance. We must avoid it at all costs. There is no other
>trait that puts others off as much as arrogance. It severely tarnishes
>the brightest intellect and the most superb technical skills. For all
>of our formal education and rigorous training, we are no better or worse
>than anyone else engaged in an honest endeavor.
>
>B is for benevolence. We must treat everyone with kindness and not let
>anger and malice have any role in our professional interactions.
>
>C is for compassion. We must strive to display it in full measure when
>interacting with patients. Compassion is particularly important in
>situations when cure of disease is impossible and when we struggle
>simply to sustain the human spirit and provide comfort for an ailing
>body.
>
>D is for dogma. We should eschew it and practice on the basis of the
>best available medical evidence, not in accordance with strongly voiced
>opinions or comfortable old habits.
>
>E is for an even temperament. We must work hard to cultivate one. Our
>responses to different situations should be predictable and consistent.
>Our patients, students, and colleagues should not have to walk on
>eggshells because we are in a bad frame of mind.
>
>F is for fair minded. We must be consistently equitable in our
>interactions with others. We always must strive to put the interest of
>our patient first and to do what is right and just, not what is
>expedient or financially profitable.
>
>G is for good humor. We must try to display one consistently. We must
>not take ourselves too seriously, and we must be willing to laugh at our
>foibles and avoid a pattern of defensiveness.
>
>H is for honesty and humility. These may, in fact, be the most
>important of all personal traits. The former is the rock upon which we
>build our professional reputation; the latter enhances our achievements
>with the soft light of graciousness.
>
>I is for insight. We must recognize not only our strengths, but also
>our limitations. We must not let ego interfere with good patient care.
>No matter what our level of training or breadth of experience, we never
>should hesitate to ask for assistance when confronted by unfamiliar
>situations.
>
>J is for judgment. We must avoid the rush to it—in making a diagnosis
>or adopting a new therapy. We must acknowledge that most serious
>mistakes in medicine result more from haste than lack of expertise.
>Therefore, we must strive to be calm, logical, and deliberate in our
>approach to patient care.
>
>K is for knowledge. We must stay informed of the facts by making a
>lifetime commitment to self-education. We must remain abreast of the
>scientific literature, read avidly and critically, and be conservative
>in evaluating apparent startling new developments. We should neither be
>the first to adopt the new nor the last to abandon the old.
>
>L is for listen. We learn the most by listening to our colleagues and
>our patients, not by talking. Sometimes the best medicine is no
>medicine at all, but rather a soft shoulder, a kind heart, and a
>receptive ear.
>
>M is for modesty, a trait that complements humility. Our counseling of
>patients, students, residents, and coworkers is far more likely to be
>heeded if we are well regarded by others rather than being perceived as
>demanding, abrasive, and insensitive.
>
>N is for negativism. We must avoid it at all costs. We must remain
>free of the company of angry, negative people, for they will be like
>anchors that weigh us down. We must strive to be part of the solution
>to a problem, not part of the problem itself.
>
>O is for open mindedness. We must be tolerant of others. Many patients
>will have lifestyles that are quite different from our own. In fact,
>many of their illnesses may be the direct result of their unhealthy
>patterns of behavior. Nevertheless, they are deserving of our respect,
>sympathy, and expertise.
>
>P is for promptness. We must be respectful of other individuals' time,
>particularly our patients. We should not overschedule ourselves so that
>we are unable to accord patients the time they deserve for assessment of
>their medical problem.
>
>Q is for quizzical. We continually must ask new questions to expand our
>fund of knowledge and enhance our efficiency. We must be willing to
>think outside the box in creating new ways to deliver compassionate,
>expert, and cost-efficient care to patients.
>
>R is for reliable. We must be steady and dependable. Colleagues and
>patients should feel secure in depending on us to complete assignments
>and honor deadlines. We must learn to say "no" politely but firmly when
>our plate is too full. When we promise to do something, we need to do
>it right and on time. R is also for respect. We must earn it, from
>both our colleagues and our patients by our conscientious, dutiful
>actions.
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>S is for sensitivity. We must display this trait in full measure in our
>interactions with patients and colleagues.
>
>T is for tact. We must be able to give constructive criticism to
>students and colleagues without crushing their self-esteem. Similarly,
>we must be able to provide realistic assessments to patients without
>taking away their hope or belittling their judgment.
>
>U is for user friendly. We must be willing to change outdated methods
>of doing business and make traditional practices (eg, admission to the
>hospital, scheduling of appointments, hospital room assignments,
>laboratory tests) convenient, dignified, and culturally sensitive for
>our patients.
>
>V is for vigor. We must avoid the phenomenon of burn-out and remain
>passionate and positive in our approach to our personal and professional
>lives.
>
>W is for work ethic. Ours must be impeccable. We must strive for the
>endurance and consistency of the long-distance runner over the flash of
>the sprinter. Slow and steady wins the race to excellence in patient
>care. W is also for well organized. Good organization is the key to
>efficiency and productivity in any profession, but particularly medicine
>where the demands on our time are intense and so often unpredictable.
>
>X is for eXacting standards. We should set the bar of performance at a
>lofty height, but not impossibly high. We should strive consistently
>for excellence but not perfection. A standard of perfection will always
>be unrealistic and elusive and invariably will lead to disappointment
>and loss of self-esteem.
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>Y is for yourself. We must be ever attentive to the proper balance
>between our professional and personal lives. We must nourish our mind,
>spirit, and body so that we are able to care properly for our loved ones
>and our patients.
>
>Z is for zero tolerance. This is the type of personal and corporate
>policy that we should have toward sexism, boorishness, and ethnic,
>racial, age, or gender discrimination.
>
>I conclude with several simple suggestions for how professionalism might
>be taught during medical school and residency training. First, faculty
>members must model desirable professional behaviors so that students and
>residents have excellent examples to emulate. Second, professional
>behavior can be taught in the context of small group seminars where
>students are presented with difficult scenarios (eg, the noncompliant
>and hostile patient, suspected drug abuse by a colleague, suspected
>financial improprieties by a partner, need for correction of
>inappropriate behavior by a student or resident during rounds). Third,
>students and residents may be assigned readings on the subject of
>professionalism and be required to attend lectures or seminars that
>discuss ethical and professional behavior. Residents and students
>should be evaluated by patients, ancillary staff, and faculty concerning
>their behavior. Finally, as is now mandated by the Accreditation
>Council on Graduate Medical Education and the Residency Review Committee
>for Obstetrics and Gynecology, professional behavior should be brought
>to the forefront of the curriculum and made one of the major criteria
>for student or resident promotion and graduation.
>
>Reprints are not available. Address correspondence to: Patrick Duff,
>MD, University of Florida, College of Medicine, Department of Obstetrics
>and Gynecology, Division of Maternal-Fetal Medicine, P.O. Box 100294,
>Gainesville, Florida 32610-0294; E-mail: duffp@obgyn.ufl.edu
>
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>Copyright © 2002 by The American College of Obstetricians and
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>Gynecologists
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>Published by Elsevier Science Inc.
>Visit Obstetrics & Gynecology online at http://www.greenjournal.org
>
>--
>"Life is neither the notes nor the silence between the notes, but the music that
> arises out of sound and silence felt as a living whole. Stop choosing...between
> chaos and order, and live at the boundary between them, where rest and action
> move together..." David Whyte
>
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art fougner, md
ich bin ein New Yorker
