Much study has been done on how to promote the most important attribute physicians must have in order to fulfill their sworn duty: that of professionalism, defined by Dr. David T. Stern, editor of Measuring Medical Professionalism, as a strong foundation of knowledge, communication skills, and ethics upon which four pillars stand to support this temple: excellence, humanism, accountability, and altruism. The vicissitudes of modern medical practice have instigated a debate about how doctors, especially those in training, can be taught the virtues of upright professional behavior in an era when regulations limit their hours at work. For practicing physicians such frustrations as the insurance bureaucracy and the pressure to generate visits can erode professionalism, leading to unhappiness and behavior unworthy of a healer.
Dr. Hildreth is a medical oncologist in private practiceThe entire medical community recognizes the need to teach and measure professionalism and its progeny, quality of care. What is sorely lacking is information for patients and families on how to find doctors who are committed to these ideals.
Well, what the heck—let me have a crack at it. Here are four traits that I believe serve to distinguish physicians who practice with professionalism, and they can be identified at the very first visit.
1. Are they cordial, or standoffish? I will never be persuaded otherwise that the doctor-patient bond is not a devotion. Doctors should introduce themselves as if they are pilots of a sometimes frightening airplane journey to strange lands. They should greet all who are in the room and set minds at ease. You’re a doctor, not a police officer at a crime scene! We should always be friendly, or if the scenario is grim at least be respectful.
2. Are they meticulous with their questions and examination, or rushed? Beware of doctors who interact with you as if there was a time bomb ticking somewhere in the room. The more we know about your past, your family, and your life the more likely empathy, the noble soother, has a chance to help with your healing.
3. Are they keenly observant of the mystery of your case, or so preoccupied that they become purblind to the solution? Doctors who practice mindfulness immerse themselves in the particulars of you, thus improving the chances of finding clues that will reach the correct diagnosis. Listening, freeing the mind of outside distractions is the best way to avoid missing a key sign or symptom.
4. When they reach the limit of what they know about your case are they inquisitive, or uninterested? Nothing bothers me more than doctors, who upon encountering a topic that they know little about (or long forgot), shrug their shoulders and smile. Ignorance, that sly assassin, is always ready to squeeze a few more drops of poison into our brain. We must never give ignorance a place to grow. Doctors who constantly learn, constantly increase their ability to give you the best treatment.
I like to think of medical professionalism as the quest to become and remain a patient champion, one who will fight for patients no matter what end is destined for them. To put it simply, the consummate professional is the doctor who says, “I value your life as much as I value my own.”
