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Professionalism / Behavior

Professionalism or professional behavior are the "in buzz words” today. As educators we must teach it; as practitioners we must demonstrate it; as professionals we must "role-model” it; as consumers/students/patients we expect and demand it. "Professionalism” can be applied to any endeavor such as sales, auto repair, or medicine.

The classic definition is that professionalism is the expertness characteristic of a professional person. So the definition of a "professional person” implies a person with specialized training.

We are given manuals to describe it; we take part in workshops to portray it; we attend lectures to hear of its importance; we analyze it; and we entertain and evaluate critiques of our actions.

So just what is this behavior called "professionalism” that we want to see in our practitioners? What idiosyncrasies or characteristics do we have to develop in order to exhibit "professionalism”?

In defining professionalism perhaps we can look at professional behavior as a wheel whose eight spokes support a hub. In this model, the hub would be the appropriate basic skills and knowledge that we would want any professional to possess regardless of their specialty. The supporting eight spokes could be:

  • Altruism which would be defined as an unselfish, true intent of one’s behavior.
  • Responsibility/Accountability referring to knowing what the rules are that govern one’s behavior and thus knowing what is expected of you and the willingness to have it critiqued.
  • Leadership we could assume should be a quality that any professional should be able to show. This would include being concerned about the very profession one is engaged in, in addition to one’s own individual performance as well as the desire to assist someone else with their striving to be "professional”.
  • Caring and compassion are elements of behavior that involve being sensitive to the needs of someone else such as a patient, a student, a colleague, or a superior.
  • Communication is important in being professional because not only should one be sensitive to the needs of another, but the desire and ability to want to be understood is equally important.
  • Excellence/Scholarship are a blend of characteristics that equate with maintaining an up-to-date awareness of one’s profession as well as one’s personal skills. This should be an ongoing process.
  • Respect is a trait that not only translates into regarding people as individuals, but treating individuals in a fair or just manner as well. Quite often self-respect is equally as important as respect for others.

Finally, in describing "professionalism,” the profile (or wheel) would not be complete without the inclusion of Honor/Integrity as a supporting spoke in the wheel. We would expect someone who is professional in behavior to be truthful and honest. This also implies that "professionalism” should entail having conscience.

It is important to understand that if one is exhibiting "professionalism” then he/she is acting out and thus demonstrating what he/she believes. There is a difference between intent of behavior and appearance of behavior, just as there is that fine line difference between one’s morality and one’s ethical behavior. The hub and the spokes in the wheel of professionalism may all exist in "intention” (or one’s moral convictions). But only when they are acted out,or in other words, shown in appearance (their ethical behavior), will professionalism be demonstrated.

Another approach is to look at "professionalism” as a blend of three elements; "humanism," "rules” and "context of behavior.”

"Humanism” is a combination of three traits. One "human” trait would be showing compassion; another is demonstrating sensitivity, and the third is expressing desire. In the clinical setting it would be the practitioner with the patient; in the gas station it would be the mechanic with the customer. Even though in the world of science we are discovering other species that might be exhibiting some of these abstract characteristics that we have always cherished to be what separates the human species from all others, nevertheless, when we think of "humanism” we certainly include the properties of compassion, sensitivity, and desire. Shouldn’t professionalism show signs of humanism?

By "rules” we mean functioning within appropriate guidelines, which in healthcare practice would be interpreted as: recognizing existing symptoms; ordering and evaluating proper tests; and then prescribing appropriate treatments. The teacher, the real estate broker, the baby sitter also operate within accepted guidelines Recognizing that behavior is influenced by "rules” is also implying that there is recognition of "right and wrong”. If we don’t like the rule, we think it is wrong (we don’t agree that this is the best medication) then we look to change the rule, legitimately. For example we look to change the medication via acceptable, proven trials establishing another medication. Shouldn’t professionalism include understanding of "expected, acceptable” behavior?

The third element in the blend of "professionalism” is the "context of behavior” The behavior of the professional in the realm of healthcare revolves around patient contact. With an attorney it would be client contact in an office; with a salesman it would be the consumer in the store. This entails attempting to understand the frame of mind of the patient along with any cultural characteristics. The environmental setting, be it hospital or private office, may influence behavior between practitioner and patient. Also in the mix would be the treatment of the patient on a case by case basis. That is creating a feeling that each patient is unique. The "professional” with the proper behavior can make the patient feel as if he/she is unique, even though the practitioner has frequently seen the same malady. When you approach the salesperson in the store, don’t you like to feel as if you are the only customer that he/she is concerned with at that moment? Shouldn’t professionalism demonstrate relevance of behavior?

Of course, when we consider what "professionalism” is, we cannot avoid understanding the fine line separating formal, professional behavior from informal, unprofessional behavior. Having physical contact, meaning merely putting a hand on one’s shoulder, might easily be misconstrued as unprofessional behavior. Our sensitivities and definitions of civilities have undergone change. As a result what may be an attempt at relaxing someone might be interpreted as exercising overly informal or unprofessional behavior. Thus when educating a potential caregivers, it is not enough to teach them how to diagnose a pheochromocytoma, or how to treat asthma, or how to rehabilitate a surgically repaired knee…it is also important that we teach, with clarity, just what is expected of them in terms of their behavior.

The bottom line is that "professionalism” is quite important, especially in the practitioner-patient relationship because it is a more intimate relationship, than for example, the relationship with a salesperson, or a mechanic, or even an attorney). So in the context of the practitioner-patient relationship, professionalism offers a very concrete foundation with which to establish the credibility between the caregiver and the patient and certainly the compliance thereafter, for the best results and improved health.

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