Introduction to

Medical Professionalism
(I)
Aamir A Hamza, MD (U of K), MD (SMSB) Hon.
Associate Professor of General Surgery, University
of Bahri

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 Objectives

• Introduction
• Role of the physician
• The social contracts
• MP in different context

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 Professionalism

Excellence Accountability

Humanism Altruism

Sound ethics

Communication skills

Clinical competence (knowledge)

4
 Roles of the Physician

• Healer Served simultaneously

Analyzed separately
• Professional

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 Attributes
Physician
Healer Professional

Caring and Autonomy

compassion Competence
Commitment Self-regulation
Insight
Confidentiality Responsibility
Openness Altruism to society
Respect for the
healing function Integrity and Team work
Respect patient honesty
dignity and Morality and ethics
autonomy Responsibility to the
Presence profession
The primary role is
that of the healer
 The Social Contract

• The social contract in health care is based

on professionalism.

• It serves as the basis for the expectations of

medicine and society.

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Society Profession

Patient expectations Physician

obligations

Professionalism
 Fundamental to this social contract
is trust:

Physician Patient

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 Society’s Expectations of Medicine’s Expectations of
Medicine Society

• to fulfill the role of the • trust

healer • autonomy
• guaranteed competence • self-regulation
• altruistic service • Health Care System
• morality, integrity, honesty – value-laden
• accountability – adequately
• transparency funded
• source of objective advice • role in public policy
• promotion of the public • monopoly
good • rewards (respect, status,
financial)

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As professional, physicians are
committed to the health and well-being
of individuals and society through
Ethical practice

Profession-led regulation

High personal standards of behaviour

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 Medical Professionalism
Medical Organizations

ABIM AAMC
American Board Association of
of Internal American Medical
Medicine Colleges

CMA GMC UK
Canadian Medical General Medical
Association Council
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 1. ABIM

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 Physician charter
Fundamental
Principles
Primacy of patient welfare.
Patient autonomy.
Social justice.

Professional Professional competence.

Responsibilities Honesty with patients.
Patient confidentiality.
Maintaining appropriate relations with patients.
Improving quality of care.
Improving access to care.
A just distribution of finite resources.
Scientific knowledge.
Maintaining trust by managing conflicts of interest.
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Professional responsibilities.
Fundamental
Principles
Primacy of patient
welfare.
Patient autonomy.
Social justice.
Guide to understanding physicians’ professional
responsibilities to individual patients and society as a
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Fundamental
Principles

Primacy of
patient welfare
• Is based on a dedication to serving the
interest of the patient.

• Market forces and societal pressure must

not compromise this principle.
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Fundamental
Principles
Patient
autonomy
• Physicians must be honest with their
patients and empower them to make
informed decisions about their
treatment.

• Patients’ decisions about their care must

be vital and respected.
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Fundamental
Principles

Social justice
• Fair distribution of health care resources.

• Eliminate discrimination in health care,

whether based on (race, gender, socioeconomic
status, ethnicity, religion, or any other social category).

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 Physician charter
Professional Professional competence.
Responsibilities
Honesty with patients.

Patient confidentiality.

Maintaining appropriate relations with patients.

Improving quality of care.

Improving access to care.

A just distribution of finite resources.

Scientific knowledge.

Maintaining trust by managing conflicts of interest.

Professional responsibilities.
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 Physician charter
Professional
Responsibilities
Professional competence

Physicians must be committed to lifelong

learning and be responsible for
maintaining the medical knowledge and
clinical skills necessary for the provision
of quality care.

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 "Education is a lifelong process, in which the
student can make only a beginning during his
college course"

Sir William Osler

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Professional
Responsibilities
Honesty with patients.
• Patients are completely and honestly informed
before consented to treatment.

• Whenever patients are injured as a consequence

of medical care, should be informed promptly
(compromises patient and societal trust).

• Reporting and analysing medical mistakes

provide the basis for appropriate prevention and
improvement strategies.

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Professional
Responsibilities
Patient confidentiality
• Safeguards be applied to disclosure of patient
information.

• This commitment extends to discussions with

relatives and others.

• Electronic information systems only to the

treating team.

What if patients endanger others?

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Professional
Responsibilities
Maintaining appropriate
relations with patients.

Given the vulnerability and dependency of

patients, certain relationships between physicians
and patients must be avoided.
(personal financial gain, or other private purpose).

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 End of previous lecture
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 Introduction to
Medical Professionalism
(II)
Aamir A Hamza, MD (U of K), MD (SMSB) Hon.
Associate Professor of General Surgery, University
of Bahri

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 Physician charter
Fundamental
Principles
Primacy of patient welfare.
Patient autonomy.
Social justice.

Professional Professional competence.

Responsibilities Honesty with patients.
Patient confidentiality.
Maintaining appropriate relations with patients.
Improving quality of care.
Improving access to care.
A just distribution of finite resources.
Scientific knowledge.
Maintaining trust by managing conflicts of interest.
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Professional responsibilities.
 Physician charter
Fundamental
Principles
Primacy of patient welfare.
Patient autonomy.
Social justice.

Professional Professional competence.

Responsibilities Honesty with patients.
Patient confidentiality.
Maintaining appropriate relations with patients.
Improving quality of care.
Improving access to care.
A just distribution of finite resources.
Scientific knowledge.
Maintaining trust by managing conflicts of interest.
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Professional responsibilities.
 Physician charter
Fundamental
Principles
Primacy of patient welfare.
Patient autonomy.
Social justice.

Professional Professional competence.

Responsibilities Honesty with patients.
Patient confidentiality.
Maintaining appropriate relations with patients.
Improving quality of care.
Improving access to care.
A just distribution of finite resources.
Scientific knowledge.
Maintaining trust by managing conflicts of interest.
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Professional responsibilities.
 Physician charter
Fundamental
Principles
Primacy of patient welfare.
Patient autonomy.
Social justice.

Professional Professional competence.

Responsibilities Honesty with patients.
Patient confidentiality.
Maintaining appropriate relations with patients.
Improving quality of care.
Improving access to care.
A just distribution of finite resources.
Scientific knowledge.
Maintaining trust by managing conflicts of interest.
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Professional responsibilities.
 Physician charter
Fundamental
Principles
Primacy of patient welfare.
Patient autonomy.
Social justice.

Professional Professional competence.

Responsibilities Honesty with patients.
Patient confidentiality.
Maintaining appropriate relations with patients.
Improving quality of care.
Improving access to care.
A just distribution of finite resources.
Scientific knowledge.
Maintaining trust by managing conflicts of interest.
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Professional responsibilities.
Professional
Responsibilities
Improving quality of care

Physicians must be dedicated to continuous

improvement in the quality of health care.
• Maintaining clinical competence
• Reduce medical error,
• Increase patient safety,
• Minimize overuse of health care resources,
• Optimize the outcomes of care.
• Develop and apply better measures and quality of
care

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Professional
Responsibilities
Commitment to improving
access to care
• Availability of a uniform and adequate standard
of care.

• Individually and collectively strive to reduce

barriers to equitable health care.

• A commitment to equity entails the promotion of

public health and preventive medicine, as well
as public advocacy.

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Professional
Responsibilities
A just distribution of finite
resources
• Provide health care that is based on
the wise and cost-effective management
of limited clinical resources.

• For appropriate allocation of resources

requires avoidance of unnecessary tests
and procedures.

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Unnecessary services
– exposes one’s patients to avoidable harm and
expense
– diminishes the resources available for others.

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Professional
Responsibilities
Scientific knowledge

Physicians have a duty to

• uphold scientific standards,
• promote research,
• create new knowledge
• ensure its appropriate use.

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Professional
Responsibilities
Scientific knowledge

• The profession is responsible for the integrity

of this knowledge,

(based on scientific evidence and

physician experience).

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Professional
Responsibilities
Maintaining trust by managing
conflicts of interest

• Medical professionals and their organizations

have many opportunities to compromise their
professional responsibilities by pursuing private
gain or personal advantage.

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Professional
Responsibilities
Commitment to professional
responsibilities

• work collaboratively to maximize patient care,

• be respectful of one another,
• participate in the processes of self regulation,

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 2. Association of American
Medical Colleges(AAMC)

• The AAMC uses Swick’s list of attributes as its

working definition.
• Nine attributes of behaviours that constitute MP and
that physicians must exhibit if they are to meet their
obligations to their:
– Patients,
– Communities,
– Profession.
Toward a Normative Definition of Medical Professionalism Herbert M. Swick, Acad.
4/28/2014 Med. 2000;75:612–616.
42
 Acad. Med. 2000;75:612–616.
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 Attributes

Physicians

• Subordinate their own interests to the

interests of others

• Adhere to high ethical and moral standards

• Respond to societal needs

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 Physicians

• Core humanistic values

• Accountability for themselves and colleagues

• Continuing commitment to excellence.

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 Physicians

• Commitment to scholarship and to advancing

their field

• Deal with high levels of complexity and

uncertainty.

• Reflect upon their actions and decisions.

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3. Canadian Medical Association

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As a Physician you will
function within the Roles of:
– Medical Expert
– Communicator
– Collaborator
– Manager
– Health Advocate
– Scholar
– Professional

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 4. The GMC-UK
• Patients must be able to trust doctors with their
life and health.
• To justify that trust you must show respect for
human life and you must:
– Make the care of your patient your first concern
– Protect and promote the health of patients and the
public
– Provide a good standard of practice and care
– Treat patients as individuals and respect their dignity
– Work in partnership with patients
– Be honest and open and act with integrity

Good Medical Practice

 Thanks

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