MIPS member distressed about a failure to diagnose a foreign body retained in the oesophagus of a child.
Because there was no evidence of the child swallowing an object and after several presentations, it seemed the problem was a persistent upper respiratory tract infection. Ultimately, the child was taken to the local hospital and a chest x-ray revealed the problem, a metal object in the oesophagus.
Our member called MIPS after the child’s grandmother had telephoned and complained. We discussed what had happened and as the narrative of events developed, it was clear that our member had been very professional in the care of the child, easily meeting the peer practice standard.
After we talked it through our member felt much better. The emotional impact of the event, on the member, was much diminished and he gained considerable comfort from the opportunity to positively reflect on the professionalism and patient focus that he had displayed in the care of the child. I advised the member to call the child’s mother and talk it over. He called me back and said that he was relieved as the mother was “quite calm” and accepted that his care had been diligent and reasonable in the circumstances.
Although the care of the child was the focus, it turned out that the doctor was a true beneficiary of his own professionalism as he was ultimately spared the personal trauma that many doctors experience after an adverse patient outcome.
In short, professionalism protects both the doctor and the patient.
Over many years MIPS has sought to further enhance professionalism in its members through MIPS educational and risk management presentations and member engagement with MIPS clinico-legal advisers.
Professionalism has been defined as the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values and reflection in daily practice for the benefit of the individual and community being served(1).
It is the cornerstone of our interaction with those receiving health care from us. At least to some extent, most health care professionals want to project their professional persona in a manner that is appreciated by their patients and which inspires confidence in the care being provided.
However, it is evident from the complaints being made against doctors that they do not all achieve the professional persona that they wish to project. Not all patient perceptions are positive. For example, professional stress may lead to a curt manner, lack of empathy and insufficient allocation of time to each patient.
MIPS has heard patient complaints to regulatory agencies such as, “the doctor hardly looked at me, he didn’t seem to give a …”. The doctor who was the subject of this remark was shocked to read it, felt that it was wrong and vexatiously exaggerated. But what if such remarks from patients have some basis in reality? Can we become aware that a problem might exist? Can we be better professionals? Can professionalism be learnt?
From the time we begin university we begin to acquire our professional manner from our teachers and may not be overtly aware that we begin to mimic the healthcare professionals that we look up to. At medical schools, attempts have been made to teach professionalism but it is not clear just how much impact formal teaching has on professionalism(2).
Self-awareness becomes important as we evaluate ourselves and try to improve our own performance by identifying our professional strengths and weaknesses. In an ideal world, we would all acquire insight leading to personal development, enhanced professionalism, and confidence in the medical care we provide and in the responses from our patients, confidence in the care they receive.
Further your skills
The MIPS view is that professionalism can be enhanced through continued professional development and we strongly encourage members to take part in our risk educational programs each year (see MIPS online units and webinars). Ultimately, professionalism promotes safe patient care and everyone can sleep better at night when unforeseen medical outcomes can be avoided.
Being a resilient doctor who can recover from setbacks and perform well is something we should all aim for(3). Being professional in practice is one of the best ways to be resilient and safe in the face of professional challenges.
References
1. Kirk LM. Professionalism in medicine: definitions and considerations for teaching. Proc Baylor Univ Med Centre. 2007 January; 20(1):13-16
2. Symonds IM, Talley NJ. Can professionalism be taught? Med J Aust 2013; 199(6): 380-81
3. Rowe L, Kidd M. First do no harm: Being a resilient doctor in the 21st century. 2009. McGraw Hill.
