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! Code of Medical Ethics ! Code of Medical Professionalism ! Code of Medical Collegiality

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Medicine is a PROFESSION Physicians are PROFESSIONALS

PROFESSIO
A public declaration with the force of a promise

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PROFESSIONS
Groups which declare in a public way that their members promise to act or behave in certain ways and that the group and the society may disclipine those who fail to do so

PROFESSIONS
The profession presents itself to society as a social benefit and society accepts the profession, expecting it to serve some important social goal

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PROFESSIONALISM
Subordination of own interest to interest of patients, adherence to high ethical and moral standards, respond to social needs, core humanistic values, accountability, excellence, commitment to scholarship and reflection
(Swick HM, 2000)

PROFESSIONALISM
Basis of medicines contract with society. It demands placing the interest of patients above those of the physician, setting and maintaining standards of competence and integrity and providing expert advice to society on matters of health.
(Van Der Weyden, 2000)

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PROFESSIONALISM
Is not one skill but blending and integration of a variety of skills. When professionalism is demonstrated, it tends to be thought of as the entire package.

PROFESSIONALISM
Is not an easy skill to develop, since it is make-up of many different skills all mushed together and tends to take years of experience to perfect.

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PROFESSIONALISM
Is not an inherent right, but is granted by the society. Its maintenance depends on the publics belief that professionals are trustworthy. To remain trustworthy, professionals must meet the obligations expected by the society
(Cruess, 1997)

PROFESSIONALISM
In this millennium, neither patients nor any regulatory body will accept the unprofessional doctor

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DESIRABLE PROFESSIONAL ATTRIBUTES

! Humility ! Honesty (intellectual and personal) ! Responsibility ! Reliability ! Accountability ! Alturism ! Respectfulness ! Compassion ! Sensitivity ! Tactfulness

DESIRABLE PROFESSIONAL ATTRIBUTES

A physicians academic accomplishments and clinical skills are the more impressive when they are cloaked with graciousness and modesty.

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DESIRABLE PROFESSIONAL ATTRIBUTES

Physicians recognized as professional also are mature, thoughtful, deliberate and even-tempered. They also have a sustained commitment to excellence in clinical care.

TOP 10 EXAMPLES OF UNPROFESSIONAL BEHAVIOR ! Intelectual or personal dishonesty ! Arrogance and disrespectfulness ! Prejudice on the basis of gender, ethnicity, age or sexual orientation ! Abrasive interactions with patients and coworkers ! Lack of accountability for medical errors and administrative oversights

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TOP 10 EXAMPLES OF UNPROFESSIONAL BEHAVIOR ! Fiscal irresponsibility ! Lack of sustained commitment to self-learning ! Lack of due diligence ! Personal excesses ! Sexual misconduct

CHALLENGES TO PROFESSIONALISM IN THE CHANGING WORLD

! Increasing workload ! Work-life imbalance ! Patients increasing demands and knowledge ! Commercialisation ! Financial incentive and increasing managerial pressure

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CHALLENGES TO PROFESSIONALISM IN THE CHANGING WORLD

As a result, there is growing : ! Conflict between alturism and self-interest ! Greed ! Arrogance ! Misrepresentation ! Lack of conscientiousness ! Conflict of interest

ASSESSMENT OF PROFESSIONALISM

Is a complex phenomenon

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ASSESSMENT OF PROFESSIONALISM ! Good ! Satisfactory ! Unsatisfactory ! Improvement needed

(Royal College of Obstetricians and Gynecologists)

ASSESSMENT OF PROFESSIONALISM ! Review of previous clinical cases ! Role playing and review of simulated clinical cases ! Three-hundred-sixty-degree evaluations (from patients, coworkers, peers and instructors)

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ASSESSMENT OF PROFESSIONALISM
Direct observation ( by patients, midwives, nurses and colleagues) : ! consistency in attendance at required conferences ! dress ! respectfulness in interacting with others ! respect for diversity ! responses in stressful situations (in outpatient practices, labor and delivery suites and operating room)

The requirements for professional behaviour in medicine are simple :

we must

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we must
be knowledgeable, diligent and responsible
(Patrick Duff, 2004)

we must
strive for excellence in clinical care, but recognize that absolute perfection is not possible
(Patrick Duff, 2004)

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we must
embrace humility, seek balance in our lives, consistently treat others with respects and compassion, maintain grace and dignity under fire and ultimately be decent people who conscientiously always try to do the right thing
(Patrick Duff, 2004)

COLLEGIALITY
Shared power and authority vested among colleagues

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COLLEGIALITY
Respect for ones colleagues and for their professional endeavors

COLLEGIALITY
Cooperative interaction between colleagues

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COLLEGIALITY
The relationship between colleagues

Thank You

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