Professionalism

The mission of the Oregon Medical Board is to protect the health, safety, and wellbeing of Oregon citizens by regulating the practice of medicine in a manner that promotes access to quality care.  It fulfills its mission by, among other activities, investigating and, if necessary, imposing disciplinary action upon physicians who do not uphold the standards of professionalism.

Professionalism comprises those attributes and behaviors that serve to maintain patients’ interests above the physician’s self-interest.

Professionalism means the continuing pursuit of excellence (see definition below), and includes the following qualities:

Altruism is the essence of professionalism.  Altruism refers to unselfish regard for and devotion to the welfare of others and is a key element of professionalism.  Self-interest or the interests of other parties should not interfere with the care of one’s patients and their families.

Accountability and Responsibility are required at many levels – individual patients, society and the profession.  First, there must be accountability to one’s patients and to their families.  There must also be accountability to society for addressing the health needs of the public and to ensure that the public’s needs are addressed.

One must also be accountable to the profession to ensure that the ethical precepts of practice are upheld.  Inherent in responsibility is reliability in completing assigned duties or fulfilling commitments.  There must also be a willingness to accept responsibility for errors.

Duty: Acceptance of a Commitment to Service.  This commitment entails being available and responsive when “on call,” accepting personal inconvenience in order to meet the needs of one’s patients, enduring unavoidable risks to oneself when a patient’s welfare is at stake, and advocating the best possible care regardless of the patient’s ability to pay.

Excellence entails a conscientious effort to exceed ordinary expectations and to make a commitment to life-long learning.  Commitment to excellence is an acknowledged goal for all physicians.  A key to excellence is the pursuit of, and commitment to, providing the highest quality of health care through lifelong learning and education.  One must seek to learn from errors and aspire to excellence through self-evaluation and acceptance of the critiques of others.

Honesty and Integrity are the consistent regard for the highest standards of behavior and the refusal to violate one’s personal and professional codes.  Honesty and integrity imply being fair, being truthful, keeping one’s word, meeting commitments, and being forthright in interactions with patients, peers and in all professional work, whether through documentation, personal communication, presentations, research, or other aspects of interaction.  Honesty and integrity require awareness of situations that may result in conflict of interest or that result in personal gain at the expense of the best interest of the patient.

Respect for Others is central to professionalism.  This respect extends to all spheres of contact, including but not limited to patients, families, other physicians and professional colleagues.  One must treat all persons with respect and regard for their individual worth and dignity.  One must listen attentively and respond humanely to the concerns of patients and family members.

Appropriate empathy for and relief of pain, discomfort, and anxiety should be part of the daily practice of medicine.  One must be fair and nondiscriminatory and be aware of emotional, personal, family, and cultural influences on patient well-being and patients’ rights and choices of medical care.  It is also a professional obligation to respect appropriate patient confidentiality. 

Signs of Unprofessionalism

It is sometimes by looking at what is unprofessional behavior, that the physician can obtain greater understanding of the meaning of professionalism.  The Board has seen these signs of unprofessionalism:

Abuse of Power:  Physicians are generally accorded great respect by their patients.  When used well, this power can accomplish enormous good.  When abused, it causes the opposite.  Examples of abuse of power are: 

  • Crossing sexual boundaries
  • Breaching confidentiality
  • Proselytizing a point of view in order to change a patient’s mind

Arrogance:  For a physician, arrogance is an offensive display of superiority and self-importance, which prevents the establishment of empathetic relationships.  Examples of arrogance are: 

  • Failing to listen to others
  • Abusing the social position of physicians
  • Failing to make appropriate referrals
  • Safeguarding physician interests above the patient

Greed:  When money rather than patient care becomes the guiding force in a physician’s practice.  Examples of greed are:

  • Doing procedures that have no medical indication
  • Billing fraud
  • Not providing medical documentation for services

Misrepresentation:  In the context of unprofessional behavior, misrepresentation consists of lying (consciously telling an untruth) and fraud (conscious misrepresentation of material facts with the intent to mislead).  Examples of misrepresentation are

  • Misrepresenting educational history
  • Not filling out licensing and other applications for renewal truthfully
  • Faking research
  • Inflating credentials
  • Altering charts
  • Giving expert testimony that is not truthful

Impairment:  This occurs when a physician is no longer able to give the patient the needed proper care.  Examples are:

  • Being under the influence of alcohol and/or drugs while on duty
  • Having untreated physical or mental health problems
  • Overworking, which may lead to the inability to concentrate

Lack of Conscientiousness:  This occurs when a physician does not fulfill his/her responsibilities to patients, colleagues and society.  Examples are:

  • Charting poorly
  • Abandoning patients
  • Not returning phone calls or pages
  • Not responding appropriately or refusing referrals without a good reason
  • Not providing patient records in a timely manner
  • Supervising trainees inadequately
  • Self-medicating without documentation
  • Not keeping up with the skills and knowledge advances in the scope of practice

Conflict of Interest:  When the physician puts his/her interests above that of the patient and society, it is a conflict of interest.  Here are a few examples:

  • Ordering diagnostic procedures or treatment from businesses where the physician has an interest
  • Receiving expensive gifts and/or money from drug dispensing companies, which causes undue influence
-Adopted May 2005