Professionalism in Surgery

Dennis F Pitt MD FRCS(C)Assistant Professor

Department of Surgery

University of Ottawa

•

The Oath of Hippocrates

• About to receive the degree of Doctor of Medicine, I solemnly affirm, in the presence of Almighty God, the Searcher of Hearts and the Master of all Sciences:

• So help me God to keep this pledge

Can Meds 2000 Competencies

1. Medical expert2. Communicator3. Collaborator4. Manager5. Health advocate6. Scholar7. Professionalism

A) ethics B) medical legal

C) professionalism

Ipsos Reid Public Survey

• 1. Doctors

• 2. Lawyers

• 3. Teachers

• 4. Nurse

• 5. Engineer

• 6. Accountant

• 7. Dentist

Public Perception

• 1. Education

• 2. Income

• 3. Codes of ethics and behaviour

• 4. License by examination

• 5. Self-governing

• 6. Serve the public

Public Respect

• 1. Physicians

• 2. Nurses

• 3. Pharmacists

• 4. Hospital administrators

• Altruism

• Occupation

• Vocation

• Avocation

• Calling

• Role model

• Mentor

• Empathy

• Sympathy

Profession

• A self-disciplined group of individuals who hold themselves out to the public as possessing a special skill derived from training or education and who are prepared to exercise that skill primarily in the interests of others.

Professional

• Autonomy

• Self-regulation

• Responsibility to society

• Teamwork

To Heal

• To make whole or sound in bodily conditions, to free from disease or ailment, to restore to health or soundness

Healer and Professional

• Competence

• Commitment

• Confidentiality

• Altruism

Healer

• Caring

• Compassion

• Insight

• Openness

• Respect for patient dignity and autonomy

• Respect for healing function

• Presence

Medical Professionalism

Contract between surgeon and patient

Contract between surgeons and society

The Social Contract

Society grants the profession privileges, including exclusive or primary responsibility for the provision of certain services and a high degree of self-regulation. In return the profession agrees to use these privileges primarily for the benefit of others and only secondarily for its own benefit.

Challenges to Professionalism

• Resource restraints

• Bureaucracy

• Unprofessional conduct

• Commercialism

• Industrialization

• Physician frustration

• Unions

Accountability

Accountability

• Patient

• Peers

• Hospital

• Government

• Fiscal

• Family

• Self

Examples

• Religion

• Amway

• Lay appeal board

• OMA negotiations

• Availability, affability, ability

• Disruptive physician

• Disclosure of harm

Medical Legal Handbook

• It is clear from the association’s work that a great number of legal actions are commenced by disgruntled patients who simply feel that their physician did not give them enough time or attention. The patient is therefore conditioned to view any result that is less than perfect as the fault of the physician rather than as a known complication or outcome of the procedure.

The Patient