Professionalism

Question 1

what is a professional?

Answer 1

a profession is distinguished by its being a special and reliable skill. it requires a special body knowledge - formal education - from which the skill is developed

Question 2

what does the GMC say about professionalism?

Answer 2

Patients need good doctors
Patients and doctors must work in partnership

These principles allow patients to trust doctors to act in their best interests.

Question 3

What are criticisms of professions?

Answer 3

elitist
authoritarian
self-interested
accountable to no one
credentialist

In todays society, all forms of authority and expertise are viewed with disillusionment and sometimes contempt. truth is viewed with distrust and suspect, as if it may be used to oppress people - look at the populist movements across USA and RW resurgence across the EU - Hungary and Brexit

Question 4

What did Dawson say in 1994 about professionalism?

Answer 4

ethical conduct is not produced through following rules or principles… by responding to pre-established rules, professionals become desensitised to morally relevant fact of an individual case and they become trained away from making ethical decisions.

Question 5

What is Oakshott’s first model of cultivation of virtue?

Answer 5

subconscious acquisition from immersion in community where we learn from those around us - the idssen curriculum

Question 6

What is Oakshott’s second model of cultivation of virtue?

Answer 6

explicit search for the moral ideal - activity determined not by habitat of behaviour but by reflective application of moral criteria based on intellectual training in the principles of ethics.

education and training have critical but neglected roles in strengthening the ethos of professionalism - RCP 2001

Question 7

why is fitness to practice not a very good system?

Answer 7

no filtering of spurious or vexatious complaints
gold standards applied - instead of reasonable ones
heavy reliance on record keeping
lack of expertise of those drawing up charges
poor control of costs
high suicide rates for those under investigation, as well as damaging to mental health
guilty until proven innocent

Question 8

what should professional regulation be like?

Answer 8

clear achievable standards
robust and transparent enforcement system
independent and impartial hearing
proportionate sanctions
generate respect and confidence of both professionals and the public
who pays the regulator?? GMC for public protection, but is doctor funded - funding own judge, jury and executioners

professionalism cannot be imposed by governments or a regulatory culture. it must emerge from and be sustained by doctors themselves.