Professionalism and Trust

Professionalism has been described as the moral contract that exists between the professional and the public. It is the agreement which enables the public to place their trust in professionals to put their vulnerability and needs first.

This series of workshops is a joint workstream in the Royal College of Physicians project Professionalism and Trust, led by the RCP's Dr Jude Tweedie and the Arts and Humanities Research Council (AHRC) funded project Compassion in Healthcare: Practical Policy for Civic Life, led by Professor Joshua Hordern. 

These workshops will produce text and ideas towards the RCP project Professionalism and Trust within ‘The Dedicated Doctor’ workstream by exploring the following themes:

1. Compassion, calling and citizenship

  • How should compassion be articulated as a feature of medical professionalism? How should professionalism incorporate an appropriate understanding and expression of common human frailty?
  • How should ideas of calling (or ‘vocation’) and duty be interpreted in a profession which is no longer so reliant on the often religious, especially Christian, framing of these notions? How does the now more developed role of regulatory bodies relate to these societal changes?
  • Whether and how should medical professionalism be reconceived through the lens of the civic life to which doctors contribute and the civic responsibilities by which they are bound? How might such a focus relate to the emerging healthcare landscape which is increasingly bound up with devolution of power to a local level, third sector/non-medical partnerships and ideas of patients’ own autonomy and accountability?
  • How do answers to these questions bear on the central issue of the moral contract that lies between the medical profession and society and the trustworthiness and trust which undergirds that contract?
  • How might a professional self-understanding shaped by these factors shape responses to the questions posed under points (2) and (3) below?

2. Marketization, work and management

  • Various studies have suggested that marketisation of healthcare, in its various forms, affects and redefines medical professionals and other healthcare workers as moral beings, especially with respect to tensions between monetary and clinical imperatives. If this is so, how will processes of marketization proceed and how can tensions between motivations best be understood and disciplined? Similar questions arise as under (3) with the added element of a ‘consumerist’ mindset now being predominant in large parts of the patient population. What is meant by ‘consumerism’ (attention to values/preferences vs. patient demand) and how should such developments be assessed? 
  • Should medicine still be understood as a profession (high moral ideals and self-governance) or rather as an occupation (a job which may be just a means to an end)? Is it a liberal profession of a trade? What are the risks and benefits of either definition to the practice of medicine?
  • In what ways is medical practice as a form of work being shaped by developments in healthcare management? Is good medical practice being distorted by management behaviour e.g. playing safe against negligence claims? How can developments such as “defensive medicine” be countered? How should developments in multi-disciplinary team-working shape conceptions of professionalism?

3. Intelligent technologies and authority

  • What impact will developments in machine learning/AI have on medical professionals, the organisations they work in and the patients/public they serve?
  • What strategies of accommodation or resistance might be appropriate? What is the significance of these developments for the standing/authority of medical professionals?