The Professional SAS Doctor Dr Maire Shelly Associate

The Professional SAS Doctor Dr Maire Shelly Associate Postgraduate Dean North Western Deanery

Medical Professionalism We all want good doctors. We want our doctor to be honest, properly skilled, fully up to date, to inform us, to take account of our preferences and to treat us with dignity and respect. Such a doctor we can trust. Equally we want to be confident that the medical profession is making sure that these standards of good practice are observed by all doctors, everywhere. This is the heart of patientcentred professionalism. Picker Institute

Medical Professionalism - Definition Medical professionalism signifies a set of values, behaviours and relationships that underpins the trust the public has in doctors.

Medical Professionalism - Description Medicine is a vocation in which a doctor’s knowledge, clinical skills, and judgment are put into the service of protecting and restoring human wellbeing. This purpose is realised through a partnership between patient and doctor, one based on mutual respect, individual responsibility and appropriate accountability.

Medical Professionalism - Description In their day-to-day practice, doctors are committed to: integrity, compassion, altruism, continuous improvement, excellence and working in partnership with members of the wider healthcare team. These values, which underpin the science and practice of medicine, form the basis for a moral contract between the medical profession and society. Each party has a duty to work to strengthen the system of healthcare on which our collective human dignity depends. Royal College of Physicians

Good Medical Practice • Good medical care • Maintaining good medical practice • Teaching and learning, appraising and assessing • Relationships with patients • Working with colleagues • Probity • Health

NCAS Professional Domains • • Competence Personal relationships Managing professional boundaries Consistency and reliability of practice Reflection and learning Commitment to service Leadership and integrity

Case Study Diabetic clinical team: 7 consultants, 5 SAS doctors, 6 trainees 4 Specialist nurses, 1 nurse educator Experienced Nurse Consultant (NC) recruited 18 months ago. New post, one of 12 in the Trust. High degree of autonomy, mark of success is development of new practices and partnership working. NC manages caseload supporting targets in NSF for diabetes. • • • NC to enhance the MDT – communications, documentation and referral system to specialist nurses. Conflict with some consultants (divided opinion about value of role). Difficulty implement care pathways causes conflict with Matron and wider team members who think they are being bypassed and undervalued. Other problems: MDT meetings are tense and argumentative Consultants undermine NC clinical opinion MDT meetings arranged when NC is unable to attend and his clinical care is discussed and criticised Trainees comment that they enjoy NC teaching but interrupted by arguments in OPD SAS doctor on sick leave Open gossip and speculation that not everybody is doing their share What are the challenges of this situation? How does this relate to professionalism?

Professionalism • • Competence Personal relationships Managing professional boundaries Consistency and reliability of practice Reflection and learning Commitment to service Leadership and integrity

Useful Documents • Good Medical Practice, GMC, 2009 www. gmc-uk. org • On Being a Doctor: , Kings Fund, 2004 www. kingsfund. org. uk • Doctors in Society: , RCP, 2005 www. rcplondon. ac. uk • Professionalism – dilemmas and lapses, NCAS, 2009 www. ncas. npsa. nhs. uk