By: Catherine R. Lucey, MD and Chip Souba, MD, ScD
Drs. Lucey and Souba published an article in the June 2010 edition of Academic Medicine entitled “Perspective: The Problem With the Problem of Professionalism” (see below). In today’s post, each author discusses challenges surrounding this issue and why they chose this subject for the article.
Chip Souba:
Living the values of professionalism in the face of the many challenges that physicians must deal with is no easy task. The traditional approach to shaping professionalism using “carrots and sticks” is a technical solution that usually does not alter behavior. Instead, what is required is adaptive change, beginning with asking, “What are the thoughts and feelings that lead to the ‘amygdala hijack’ that results in this unprofessional behavior?” Learning to be professional is not just a matter of gaining new information or acquiring new behaviors. Rather, it is a matter of learning a new identity, of seeing oneself differently: first as a person who needs to regain control, and then as a person who can be effective without being unprofessional.
Personal change is a complex learning problem, one that is difficult for all of us. It requires that the issues that lead to unprofessional behavior be confronted – not dodged, sidestepped, or ignored. Creating a blame-free environment that encourages people to report lapses in professionalism is necessary but not sufficient. It is also critically important for the individual who has the lapse to understand that any corrective actions are not a personal attack.
What thoughts do you have on how we can create a culture of professionalism?
Catherine Lucey:
Ensuring that physicians maintain the values of professionalism despite the acknowledged pressures they practice under is a challenge for educational and institutional medical communities. The traditional practice of dealing with breaches of professionalism with dismissal and rewarding good behavior are merely technical approaches that have little impact on future behavior. Instead, what is required is a more adaptive change – a change in the individual’s commitment to the values of professionalism. Achieving such change is a complex learning problem, difficult to make and often met with resistance. It requires a change in attitude – a willingness for the individual to confront the issues that lead to his demeaning behavior. Those who are responsible for running medical organizations must also take responsibility for ensuring that the environment – policies, procedures, staffing, compensation plans – are aligned to support and reinforce professional obligations. Too often the system sets up physicians to stumble as they are trying to live their values and serve their patients.
What strategies can we employ to help physicians realize their commitment to the values of professionalism? How can we help clinicians to make the necessary changes in their personal lives?
" target="_blank">“Perspective: The Problem With the Problem of Professionalism”
