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PROFESSIONALISM
• Placing the interests of others ahead of one’s personal interests
• First step to being a professional – decide you are one
© WRH (Sept., 2012)
ELEMENTS OF PROFESSIONALISM
IN HEALTH CARE
• Altruism
• Excellence
• Humanism
• Duty
• Accountability
• Honesty/Integrity
• Respect for Others
© WRH (Sept., 2012)
HOW IS PROFESSIONALISM JUDGED?
• Competence
• Communication
• Appearance
• Demeanor
© WRH (Sept., 2012)
SOME DON’TS OF PROFESSIONALS
• Overstepping boundaries
• Involvement in others’ affairs
• Gossip
• Personal activities at work
• Breaching confidentiality
• Bringing emotional baggage
to work
• Criticizing superiors
• Inappropriate language
© WRH (Sept., 2012)
CHALLENGES TO MEDICINE’S
PROFESSIONAL STATURE • Rising healthcare costs
• Lack of overarching health coverage
• Large geographic variations in health care
• Need for evidence-based health care
• Time constraints on healthcare providers
• Safety of health care
• Conflicts of interest
© WRH (Sept., 2012)
PRINCIPLES OF THE PHYSICIAN CHARTER
• Primacy of patient welfare
• Patient autonomy
• Social justice
© WRH (Sept., 2012)
PHYSICIAN’S CHARTER RESPONSIBILITIES
(ABIMf, ACP/ASIMf,EFIM) • Competence
• Confidentiality
• Quality of Care
• Just Distribution Resources
• Manage CoI
• Honesty
• Appropriate Relations
• Access to Care
• Scientific Knowledge
• Professional Responsibilities
© WRH (Sept., 2012)
ACGME CORE COMPETENCIES
• Patient Care
• Medical Knowledge
• Practice-Based Learning/Improvement
• Interpersonal/Communication Skills
• Professionalism
• Systems-Based Practice
© WRH (Sept., 2012)
ELEMENTS OF A PROFESSION
• Formal education
• Control over educational standards
• Self-regulation/disciplinary standards
• Scholarly journal
• Relatively high social status
• Protection from state regulation/market pressures
KR Sethuraman
Regional Health Forum (2006) 10
© WRH (Sept., 2012)
ELEMENTS OF PROFESSIONALISM
IN SCIENCE • Intellectual Honesty
• Excellence in Thinking and Doing
• Collegiality and Openness
• Autonomy and Responsibility
• Self Regulation
S. Korenman
Univ of California 2006
© WRH (Sept., 2012)
EXPANSION OF THE ELEMENTS OF
PROFESSIONALISM IN SCIENCE
1. Honesty and fairness in proposing, performing, and reporting research;
2. Accuracy and fairness in representing contributions to research proposals and reports;
3. Proficiency and fairness in peer review;
4. Collegiality in scientific interactions, communications and sharing of resources;
© WRH (Sept., 2012)
EXPANSION OF THE ELEMENTS
5. Disclosure of conflicts of interest;
6. Protection of human subjects in research;
7. Humane care of animals in research;
8. Adherence to the mutual responsibilities of mentors and students.
© WRH (Sept., 2012)
TEN ATTRIBUTES OF LEADERSHIP
Vision Integrity
Dedication Magnanimity
Humility Openness
Creativity Fairness
Assertiveness Sense of Humor
© WRH (Sept., 2012)
“Good business leaders create a vision, articulate the vision, passionately own the vision and relentlessly drive it to completion.”
Jack Welch
Former Chair and CEO
General Electric Co.
© WRH (Sept., 2012)
A LEADER HAS
Solidarity Modesty
Self-confidence Initiative
Creativity Passion
Symbolic Value
http://life.halcode.com/archives/2008/04/13/the-7-attributes-of-leadership/
© WRH (Sept., 2012)
INNER HABITS, QUALITIES AND TRAITS
OF TRUE LEADERS • Enthusiasm
• Integrity
• Self-confidence and self-reliance
• Persistence and determination in challenging situations
• Positive mental attitude
• Willingness to change and consider new opportunities
• Creativity in searching for new solutions
• Personal charisma
• Empathy towards others
• Faithfulness and fairness
© WRH (Sept., 2012)
9 RULES OF A TEAM LEADER
1. Provide purpose
2. Build a star team, not a team of stars
3. Establish shared ownership for the results
4. Develop team members to fullest potential
5. Make the work interesting and engaging
6. Develop a self-managing team
7. Motivate and inspire team members
8. Lead and facilitate constructive communication
9. Monitor, but don’t micromanage
© Vadim Kotelnikow
© WRH (Sept., 2012)
FAILURE IN LEADERSHIP
12 MAJOR CAUSES 1. Inability to organize detail 2. Unwillingness to do what they would ask another to do 3. Expectation of pay for what they know instead of what they
do 4. Fear of competition from others 5. Lack of creative thinking in setting goals and creating plans 6. The “I” syndrome 7. Over-indulgence, destroying endurance and vitality 8. Disloyalty to colleagues 9. Leading by instilling fear instead of encouraging 10. Emphasis of title instead of knowledge and expertise 11. Failure to face the negative reality 12. Being ultra-positive
Adapted from Motivate to Win, Richard Denny © WRH (Sept., 2012)
DIFFERENCES IN MANAGERS
AND LEADERS MANAGERS LEADERS
Administer Innovate
Ask how and when Ask what and why
Focus on systems Focus on people
Do things right Do the right things
Maintain Develop
© WRH (Sept., 2012)
DIFFERENCES IN MANAGERS
AND LEADERS MANAGERS LEADERS
Rely on control Instill trust
Short-term perspective Long-term perspective
Accept status quo Challenge status quo
Focus on bottom line Focus on horizon
Emulate classic good soldier Are their own persons
© WRH (Sept., 2012)
The Leader is best,
When people are hardly aware of his existence,
Not so good when people praise his government,
Less good when people stand in fear,
Worst, when people are contemptuous.
Fail to honor people, and they will fail to honor you.
But of a good leader, who speaks little
When his work is done, his aim fulfilled,
The people say, 'We did it ourselves.
Lao Tzu
~500 BC
© WRH (Sept., 2012)
DEFINITIONS
• ETHICS – Rules for acceptable behavior expected by Society
• MORALS – Rules for acceptable behavior expected by a Religious Order
© WRH (Sept., 2012)
ETHICS IN HEALTH CARE
• Biomedical Ethics: rights of patients and the public
• Professional Ethics: integrity and virtues of professionals
• Organizational Ethics: business/management of organizations
© WRH (Sept., 2012)
ETHICS REFERENCE
Hendee, W.R., Bosma, J.L, Bresolin, L.B., Berlin, L, Bryan, R.N., Gunderman, R.B., Web modules on professionalism and ethics, J Am Coll Radiol, 9: 170-173, 2012.
http://www.aapm.org/education/onlinemodules.asp
© WRH (Sept., 2012)
MODULE: ATTRIBUTES OF
PROFESSIONS/PROFESSIONALS Competence Honesty
Confidentiality Appropriate Relationships
Quality of Care Access to Care
Just Distribution Resources Scientific Knowledge
Manage COI Professional Responsibilities
© WRH (Sept., 2012)
MODULE: CONFLICT OF INTEREST
Financial Educational
Professional Recognition
Removal Disclosure
© WRH (Sept., 2012)
MODULE: HUMAN SUBJECTS RESEARCH
BELMONT REPORT’S THREE ETHICAL CONCEPTS
• Respect for persons, requiring informed consent
• Justice, requiring equitable distribution of burdens and benefits
• Beneficence, requiring risks balanced by value of knowledge generated
© WRH (Sept., 2012)
THREE IDEAS TO IMPROVE 1991
COMMON RULE REGULATIONS
Make Informed consent truly informed
Compensate for Subject harms
Peer review Human studies
Rebecca Dresser
Science 337 August 3, 2012
© WRH (Sept., 2012)
MODULE: GRADUATE AND RESIDENT
EDUCATION • Responsible Teachers
• Responsible Students
• Responsible Research Mentoring
• Need for Professional Mentoring
• Recall Question Issue
© WRH (Sept., 2012)
ISSUES OF RESEARCH MENTORING
• Whose needs come first – mentor or student?
• Should a student have a research mentor and a professional mentor?
• How to instill leadership/professionalism/ethics
• What are the responsibilities of mentors towards students?
• What are the responsibilities of students towards mentors?
© WRH (Sept., 2012)
MODULE: RESEARCH
ETHICS/MISCONDUCT
Fabrication Falsification
Plagiarism Record-Keeping
Ownership Transparency
© WRH (Sept., 2012)
RESEARCH MISCONDUCT
CHARACTER TRAITS • The Desperate – fear of failure
• The Perfectionist – failure is a catastrophe
• The Ethically Challenged – succumb to temptation
• The Grandiose – judgment doesn’t require verification
• The Sociopath – without conscience
D. Kornfeld, Wing of Zock
August 2012
© WRH (Sept., 2012)
MODULE: PERSONAL BEHAVIOR,
EMPLOYEE-EMPLOYER RELATIONS Teamwork/Demeanor Respect/Concern for Others
Accountability/Initiative Responsibility/Sense of Duty
Scholarship Commitment to Learning
Integrity Trustworthiness
© WRH (Sept., 2012)
MODULE: PROFESSIONAL/PATIENT
RELATIONS Altruism Excellence
Humanism Duty
Accountability Honesty
Integrity Respect for Others
© WRH (Sept., 2012)
MODULE: PUBLICATION
Authorship Use of Other’s Work
Redundancy Acknowledge Others
Transparency Clarity
© WRH (Sept., 2012)
CHALLENGES TO COLLEGIALITY AND
SHARING IN SCIENCE • Materials Transfer Agreements
• Patenting and Licensure
• Indemnification
• Industry/Academic Cooperative Agreements
• Publication Review
• Recognition of Others (Literature, Research Group)
© WRH (Sept., 2012)
MODULE: VENDOR RELATIONS
Independence Accountability
Publication Indemnification
Testimonials COI
© WRH (Sept., 2012)
MODULE: ANIMAL RESEARCH
History Abuses
Animal Rights Groups Regulatory/Advisory Groups
© WRH (Sept., 2012)