Following a series of professionalism workshops hosted by the Royal College of Physicians' (RCP's) 'Professionalism: The dedicated doctor - what does it take?' project, Michael Trimble, consultant physician in acute medicine at the Belfast Trust, gives us his personal reflections on the importance of compassion, calling and citizenship.
Professionalism is a word used frequently when talking about medical practice – but what does it mean and how is it applicable to modern medicine? Is it all about targets, rules and standards – or is it something more?
We talk of compassion, but is care about emotions or a process of delivering treatment? How do we, as doctors, align commitment to patients with our contracted working? What about contract disputes and the question of industrial action? On 2 March a group, including medical professionals, met to debate and discuss the concept of compassion, calling and citizenship.
However, if our work becomes little more than a list of technical elements for completion as quickly and efficiently as possible, it leaves no space for compassion
We were all touched by an extract read from a medical student’s reflection about her experience of caring for an elderly woman who was dying. In this instance she was able simply to spend time with her in her last hours, but the reality is that in routine practice no medical professional would have time to devote to one individual, amid the pressures of work. However, if our work becomes little more than a list of technical elements for completion as quickly and efficiently as possible, it leaves no space for compassion.
It was noted too that compassion often comes with a cost; the story of the Good Samaritan illustrates not just kindness but also personal risk and sacrifice. Genuine concern for the wellbeing of patients on our wards and in our clinics will ensure that we hold ourselves to account to improve standards of practice.
Sustained compassion needs time and space to flourish and to safeguard against burn out. Doctors show significant compassion to our patients, but we also need to be shown compassion ourselves. Healthcare organisations must show compassion to their teams and staff – the NHS must develop a culture of compassion.
Doctors often speak of a sense of vocation; the concept of a vocation originates from religion – usually the sense of feeling called by God to follow a certain path. Personally, as a Christian I understand that sense of calling, and that is how I view my work. However, in an age of secularism, whilst the term vocation is still used, its meaning has changed to reflect some implicit sense of purpose.
Profession is another word often linked to the notion of vocation, but again, its meaning has become diluted over time. It originally referred to occupations that required the taking of an oath of commitment to certain values and duties.
It is worth noting that the keeping of such oaths carried significant risk, even risk to one’s life. The risk of death for soldiers is clear, in some places being a lawyer with integrity still has its price, for the clergy there are parts of the world where the possibility of martyrdom remains a reality and, whilst doctors in the UK are fairly safe in their day job, there are also those who risk their lives abroad with Ebola, or those who died in the SARS epidemic in 2002.
Being professional comes at a cost, but it can be difficult to understand and agree what that cost is or should be – a cost that significantly differs to that of professional football players or singers.
So how, as medical professionals, can we reclaim the meaning and concept of professionalism for ourselves? What is a reasonable commitment to expect from the individual doctor in the 21st century?
Michael Trimble, consultant physician in acute medicine at the Belfast Trust.
Part two of Michael’s views on professionalism, compassion, calling and citizenship will be posted on the RCP blog next week.