AN INTRODUCTION TO PROFESSIONALISM Dr. Saleh S. El-Qaderi, M.D., M.H.P.Ed Faculty Development Program Medical Education

1. AN INTRODUCTION TO PROFESSIONALISM Dr. Saleh S. El-Qaderi, M.D., M.H.P.EdFaculty Development Program Medical Education Unit College of Medicine King Faisal University February 2007

2. THE BEST CAR, BUT IT HAS NO: - Guiding Map - Breaks / Compass - Speedometer - Clock Question: Can we reach our final destination ? ?

3. Qualities of Good Health Care • Safe • Effective • Patient-centered • Timely • Efficient • Equitable

4. What really happens: Many People are Harmed • Adverse event: some health problems are caused by medical management • Adverse events occur among 3-4% of hospitalized patients • About 1 in 10 results in death • Over half are preventable Sources: Brennan et al., 1991; Thomas et al., 1999

5. WHY & HOW ?? • Errors occur because of system failures • Preventing errors means designing safer systems of care

6. How to improve Safety in Healthcare Organizations • Provide leadership • Job design: • avoid reliance on memory • simplification and standardization • Promote effective team functioning • Anticipate the unexpected • design for recovery • Create a learning environment

7. Three Keys for Involving Physicians • Professionalism • With privilege comes responsibility • Core strategy must be an educational, not a punitive approach • Goal to achieve “best care” for all patients • Use existing infrastructure: Always Build on what you already have !

8. Professionalism Education and knowledge with accountability as shown by: • Licensure • Certification • Accreditation

9. EDUCATIONAL: C P D • Continuous learning • Practice improvement • Knowledge test • Peer associate ratings

10. GENERAL COMPETENCIESFOR GOOD HEALTH CARE • Patient care • Medical knowledge • Practice-based learning & improvement • Interpersonal & communication skills • Professionalism • Systems-based Practice

11. Applied Questions • Why do we need a charter on medical professionalism today? • Can a charter make a difference to physicians and to patients? • How will its impact and effectiveness be measured?

12. Definition of Profession A highly-educated, well trained, experienced group of individuals who are greatly valued by society because they are devoted to: • Advance vital knowledge through research • Transmit knowledge and skills to the next generation • Set and enforce own standards • Aiming at excellence • Value performance over personal gain

13. Definition of Professionalism • Professionalism is the process or actions through which individuals fulfill the profession’s contract with society • Professionalism is based on a set of principles and requires that individuals meet certain principled responsibilities

14. Three Fundamental Principles of Professionalism • Primacy of patient welfare • Patient autonomy • Social justice

15. Ten Commitments to Professionalism

16. 1 Commitment to Professional Competence • Lifelong professional development • Maintenance of competence

17. 2 Commitment to Honesty with Patients • Inform patients completely and honestly before and after treatment • Empower patients to participate in decisions affecting their health • Disclose fully and promptly all medical errors

18. 3 Commitment to Patient Confidentiality • Adhere to all safeguards governing the disclosure of patient information • Disclose confidential information only when considerations of public interest override the interests of privacy

19. 4 Commitment to Maintaining Appropriate Relations with Patients • Recognize inherent vulnerability and dependency of patients • Never exploit patients for sexual advantage, personal financial gain, or other private purpose

20. 5 Commitment to Scientific Knowledge • Uphold scientific standards • Promote research to create new knowledge • Ensure appropriate use of scientific information

21. 6 Commitment to Professional Responsibilities • Participate in the processes of self-regulation • Assist in establishing educational and standard-setting activities • Accept external scrutiny of professional performance

22. 7 Commitment to Improving Quality of Care • Work collaboratively to: • Reduce medical error • Increase patient safety • Minimize overuse • Optimize outcomes of care • Help develop and implement better measures of quality health care

23. 8 Commitment to Improving Access to Care • Try hard to reduce barriers to equitable health care • Promote the health of the public without concern for self-interest

24. 9 Commitment to a Just Distribution of Resources • Base individual patient-care decisions on cost-effective management of limited resources • Work collaboratively to develop clinical guidelines • Scrupulously avoid superfluous tests and procedures

25. 10 Maintain Trust by Managing Conflicts of Interest • Recognize the existence of many opportunities to pursue private gain • Prepare to resist temptation • Disclose all conflicts of interest involving professional activities

26. Challenges to Professionalism • Human nature:self-interest, self-protection • Unfulfilled expectations:it’s no rose garden • Large temptations: it’s easy pickings • Peer pressure:“everyone else is doing it” • Commercialism:success of market at controlling costs obscures the danger

27. Critical Issues in the Future • Access to care • Quality defined as safety and oversight • Use of scarce resources

28. Core Strategy: Educate the Professional • The goal: achieve “best care” for all • Allow input and dialog • Seek consensus with rational exceptions • Document and measure • Feedback loops © 2002 Institute for Healthcare Improvement

29. Use Existing Organizational Infrastructure • Group practices • Hospital medical staffs • Regional & national medical societies • Specialty societies © 2002 Institute for Healthcare Improvement

30. Summary The “Vision” is a system that uses the best knowledge, focuses intensely on patients, and works across healthcare providers and settings. Achieving this ideal will require bridging a large gap between today’s system and the possibilities of tomorrow. © 2002 Institute for Healthcare Improvement

31. “It is not the strongest of the species that survives, not the most intelligent, but the one most responsive to change.”