Professionalism in medicine
PROF Edelstein is the originator of the term “professionalism”, when we asked our colleagues to define this term, most of them shrugged their shoulders and mentioned a few admirable traits.
Several medical ethicists argue prohibited behaviours that professionals do not follow. Abraham Flexner expanded the definition to include the elements of excellence, self-regulation and opined that it should be increasingly unselfish for helping a patient.
Medicine is really a science more akin to physics and chemistry based on the knowledge and clinical experience.
In fact, knowledge is not enough but patient’s welfare is pre-eminent. Professionalism is “a trust-generating promise, commitment to excellence, humanism, accountability and altruism.”
In this context, Codman is acknowledged as the father of such ideas, while Florence Nightingale has been considered to be a true pioneer of her professional dedication while treating infections and working on cleanliness during 1850 Crimean War.
Similarly Scribonius an exponent of health in life asserted that professionalism begins from the clinical competence, understanding ethics and the law which is necessarily not sufficient to treat your patients.
He wrote a in his treatise in Latin entitled On Remedies. , and described Medicine is not merely an art or a science, but a profession, which is outlined by the moral conduct of a physician.
Scribonius cited the code of Hippocrates that medicine should heal and not harm the patient.
He emphasized the need for technical competence and to make use of it for the benefit of the sick, which is fundamental to our understanding of professionalism.
The oath has been adopted by all those practicing medicine, as the concept of an oath has its own merit to provide best services with compassion, respect for human dignity, and integrity.
According to Edward Pellegrinobeen, the oath was created by the doctors, for the doctors, who regarded themselves as a skilled craftsmen and are best for the patient, known for their reputation and based on virtues, behaviors and professional identity.
In short, professionalism focuses on moral character, reasoning, humanism, appropriate actions for correct values and ethical principles of justice and moral reasoning.
Transgressions or lapses are attributed to a failure of these virtues. Accordingly, behaviour-based professionalism focuses on competency, developed by the Medical Education, dispositions, and aspirations.
Edelstein quoted that the physician is like a soldier, and is bound in lawful obedience to medicine by his oath.
The patient-physician relationship is not an agreement. A physician has a special knowledge and the skills that he can heal or help the patient.
The American Medical Association has stressed Percival’s work when he published its code of ethics in 1847.
Similarly Pindar mentioned about Asclepius a physician known as a god of medicine who used to receive money from his patients.
He was killed by Zeus who considered him to be involved in a dreadful crime against ethics. Ophthalmologists who wish to join as members of the American Academy of Ophthalmology must follow the Code of Ethics, primarily to protect the individual patient.
Transgressions from this ethical civility is considered a gross embarrassment of the whole profession.
The temptation to cross the professional boundaries for pursuit of financial gains, is not unique. Will the fate of professionalism in Medicine remains unfinished in this era?
—The author is associated at Fauji Foundation Medical University College, Rawalpindi.
