Advancing Medical Professionalism

The Advancing Medical Professionalism report, co-authored by Professor Joshua Hordern, and Dr Jude Tweedie and Dame Professor Jane Dacre of the Royal College of Physicians, aims to support doctors’ satisfaction in their profession and promote innovative, high quality healthcare for patients.

Advancing Medical Professionalism (AMP), argues that enabling and supporting doctors to develop their professional identities is vital to ensuring their well-being and the satisfaction with their work that will keep them in the profession.

AMP took as its starting point the RCP’s 2005 definition of professionalism as the ‘set of values, behaviours and relationships that underpin the trust the public has in doctors’ and built on this both with Professor Hodern’s theological investigation of compassion and a series of workshops with healthcare staff, patients and other stakeholders to explore what professionalism might mean for doctors in the future.

The process helped identify seven key aspects of doctor’s working lives essential to professionalism, highlighting the many different roles we expect our modern doctors to fulfil. From this, the report authors developed practical strategies and approaches to promote professional values, skills and attributes in each area. 

Seven key aspects of professionalism. Doctor as:

• Healer
• Patient partner 
• Team worker
• Manager and leader
• Patient advocate
• Learner and teacher
• Innovator 

Advancing medical professionalism in practice (examples from AMP)  

Doctors increasingly face ethical dilemmas and clashes in professional values, such as the desire to advocate for the best care of a single patient while needing to husband finite resources, or the obligation to voice concerns about patient care, knowing this may result in reprisals for themselves or others. Professionalism cannot provide a model answer for every situation but developing professional values, skills and attributes can empower doctors to navigate the challenges they face.

Doctor as healer: The concept of the doctor first and foremost as a healer is at the core of medical professionalism and the sense of vocation which brings most people into the profession. The report explores how reconnecting with the idea of healer – through a focus on the little things such as how patients are treated or the willingness to have difficult conversations about issues such as end-of-life care – can help boost physician morale and satisfaction. The values of compassion, respect and integrity are central to the role of healer.

Doctor as advocate (on patient safety): The case of Dr Hadiza Bawa-Garba, a paediatrician found guilty of manslaughter by gross negligence, whose own reflective practice was used as evidence against her, sent shock waves through the medical profession. A patient safety culture informed by professional values will be genuinely transparent and non-judgemental. It will hold staff accountable for unprofessional conduct yet not punish them for human mistakes.

Doctor as team worker: The growing complexity of healthcare makes good teamwork increasingly important. A professional approach to teamwork will foster communication and the ability to reflect on and learn from events, and build a positive working culture even in short-lived or quickly changing teams. Team building should be recognised as an important process and time should be allowed for it by leaders and managers. 

Doctor as innovator: Artificial Intelligence, machine learning and digital technologies have perhaps the greatest potential to impact on how doctors work. They also raise many questions about the doctor’s role, values, ethics and medical professionalism. Smartphones are already enabling consultation at a distance; wearable technology can automatically collect physiological and health data from patients; and machine learning is expected to allow more efficient use of data.

AMP argues that technology will not displace but rather adjust the role of doctors. Experienced doctors can build on the combination of machine-generated data, their own previous experience, patient contact, and professional insight to form a diagnosis and keep the human encounter at the heart of healthcare. As technologies continue to change healthcare, doctors can innovate by exploring aspects of other disciplines - including philosophy, theology, and history – which can shed light on these changes, so that they achieve the best blend of innovation and patient care.

About the report

Advancing Medical Professionalism was authored by Dr Jude Tweedie, research fellow to the president, RCP; Professor Dame Jane Dacre, immediate past president of the RCP; and Professor Joshua Hordern, Associate Professor of Christian Ethics, University of Oxford. Professor Hordern is a member of the RCP’s Committee for Ethical Issues in Medicine. Dr Richard Smith added to, and extensively edited, the report.

Now Oxford Healthcare Values Partnership is working with colleagues in Oxford University Hospitals NHS Foundation Trust to embed the report’s approaches in clinical training and practice.

The project which underpinned Joshua Hordern's involvement in the report was entitled Compassion in Healthcare: Practical Policy for Civic Life. This project was generously funded by an Arts and Humanities Research Council Leadership Fellows Award (AH/N009770/1). 

Find out more

With fully referenced sources for further information and a practical exercise at the end of each chapter, Advancing Medical Professionalism is available HERE and its short, accessible summary HERE.

Read our blog about Advancing Medical Professionalism HERE