Thoughts on professionalism

Historically, three recognized professional careers existed: medicine, law, and the clergy. The people whom each of these professions served looked for guidance, legitimate leadership, and a strong sense of hope. The people expected outstanding service, the safety of trusted relationships, and the leaders of these professions to practise and conduct themselves in an ethical manner.

Since I didn’t choose a career in law and I’m not a member of the clergy, I can only speak to the valued profession of medicine. And in medicine today, those long-established tenets continue to be held in high esteem. Physicians take great pride in our profession’s longstanding traditions of altruism, the use of scientific evidence, and the value and merits of the social contract. As doctors of medicine we strive for professionalism in every aspect of our working lives. It is the cornerstone of our relationships with patients, with one another, with other health care providers, and most certainly with society. As of late it has become increasingly difficult to live up to those standards.

What does it mean to be a doctor within the landscape of BC today? Our College feels that the social order has changed. And I sense feelings of angst and discomfort among our colleagues in the many areas of the province that I travel to. Over the last decade I have witnessed, and our peers are experiencing, the de-professionalization of medicine—a sense that the foundation of our professionalism is being eroded.

Medicine is changing faster than ever before and we are at a crossroads. Advancements in medical treatments and therapies, combined with societal changes and changes within the health care system itself, are impacting the way physicians practise medicine. Many of these changes have us feeling burned out and, yes, skeptical of the future of health care. We struggle with a fragmented system in which our patients are said to fall through the cracks, yet it is our patients and society who are looking to us as the medical profession for meaningful solutions. This is a great burden to carry, yet, at this time when the corporatization of medicine is the single biggest challenge to our professionalism, we have significant and determined obstacles ahead that require us to unite and rally strongly as a profession.

Health care is delivered through a network of relationships that encompasses many different health care professionals, administrators, and government, and of course our patients are central to this. These relationships, which are at times challenging, are influenced by individual behavior, constantly changing societal norms, and a political environment that has trouble planning and visioning for anything longer than a single election cycle or government. As a result, when changes occur in any of these areas, our core professionalism can be challenged.

In medicine, professionalism is very much about building and maintaining these relationships as we strive to provide quality patient care. And, as an association of doctors, we must deepen and expand our leadership in quality of care to and for our patients, and this can’t be accomplished without professionalism. Professionalism encompasses the attitudes, skills, behaviors, attributes, and values that are expected from those to whom society has extended the most notable privilege of being considered a professional.

We doctors are extremely fortunate. Years ago we chose, and today we get to experience, a humbling and meaningful professional career. We are highly educated; indeed, we are the experts in modern-day medicine, and we simply must not take that for granted. We get to be who we want to be in the context of the responsibility of being a doctor. We are a profession that is entrusted with serving our patients to the best of our abilities and expertise. And that, dear colleagues, is a great honor. In choosing to uphold the virtues of professionalism and by holding one another accountable, we can enhance our professional satisfaction and the patient experience, and provide the highest standard of health care. And isn’t that what being a doctor is all about?
—Alan Ruddiman, MBChB
Doctors of BC President