While individual doctors have their own personal beliefs and values, there are certain

professional values on which all doctors are expected to base their practice. Doctors have a
duty to make the care of patients their first concern and to practise medicine safely and
effectively. They must be ethical and trustworthy. Patients trust their doctors because they
believe that, in addition to being competent, their doctor will not take advantage of them
and will display qualities such as integrity, truthfulness, dependability and compassion.
Patients also rely on their doctors to protect their confidentiality.
Doctors have a responsibility to protect and promote the health of individuals and the
community. Good medical practice is patient-centred. It involves doctors understanding that
each patient is unique, and working in partnership with their patients, adapting what they do
to address the needs and reasonable expectations of each patient. This includes cultural
awareness: being aware of their own culture and beliefs and respectful of the beliefs and
cultures of others, recognising that these cultural differences may impact on the doctor
patient relationship and on the delivery of health services.
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 health matters.
The principle and responsibilities of medical professionalism must be clearly understood by
the profession and society. Essential to this contract is public trust in physicians, which
depends on their integrity and that of the profession.
Professionalism embodies all the qualities described here, and includes self-awareness and
self-reflection. Doctors are expected to reflect regularly on whether they are practising
effectively, on what is happening in their relationships with patients and colleagues, and on
their own health and wellbeing. They have a duty to keep their skills and knowledge up to
date, refine and develop their clinical judgment as they gain experience, and contribute to
their profession.

Treating patients in emergencies requires doctors to consider a range of issues, in addition to

the patients best care. Good medical practice involves offering assistance in an emergency
that takes account of your own safety, your skills, the availability of other options and the
impact on any other patients under your care; and continuing to provide that assistance until
your services are no longer required.
Health care worker professionalism has become a subject of great concern to the public,
those who teach medicine and practicing physicians themselves. In Kenya, various
newspaper articles have highlighted medical cases that have demonstrated lack of
professionalism. A recent article appearing in the Standard Newspaper alleged that a doctor
left a patient on the operating room table with an un-sutured surgical wound and went to the
pub to drink alcohol. A similar article in the Daily Nation alleged that a doctor was paid by a
member of parliament to forcefully perform an HIV test on a young woman with whom the
MP wanted to have sexual relations. Such stories, though not substantiated, demonstrate a
severe lack of professionalism, and reflects the depth of the problem and its wide variation
in occurrence. Ultimately, such unprofessional and unethical behaviour damages public trust
in physicians and in the medical services as a whole.
Historically, physicians have been well respected by their communities and viewed as
professional healers with high standards of behaviour. Although the role of the healer has
not changed, the understanding of professionalism has been impacted by societal pressures
and professional needs. There have been many changes in the practise of medicine over the
recent years which have impacted the professional attitudes and behaviours of health care
workers.
These changes includes; technological advances leading to reduced patient-physician
contact, demographic transitions leading to questioning of traditions and authorities,
population increases affecting the doctor-patient ratio and thus reducing the allotted time for
each patient, and finally, commercialization of medical care reducing accessibility due to
cost and focus of doctors and corporate bodies on profit over care.

The understanding and increased importance of medical professionalism and its

implementation within medical settings is not new. In the US, from the late 1960s, two
major pathways of categorizing and understanding professionalism emerged. The first is
explained by the bioethicists as mainly concerned with a persons rights and principles. This
approach to professionalism asks the questions: What should I do, and how should it be
done? The main principles involve the concepts of autonomy, justice, beneficence and nonmaleficence. Secondly, professionalism is understood to be a virtue-based practice with
documented codes such as the Hippocratic Oath.
previous studies of professionalism have focused on the views of one cadre of health care
worker, for example only students or only consultant specialists. In order to inculcate a
Kenyan surgical practice that upholds professionalism, we first need to understand the views
of clinicians, trainees and patients in regards to professionalism within our context. Then we
can avoid introducing professionalism concepts that do not apply to the local context and
hence are not successfully taken
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Ojuka DK, Olenja JM, Mwango'mbe NJ, Yang EB, Macleod JB (2016). Perception of
medical professionalism among the surgical community in the University of Nairobi: a
mixed method study.