The Professional SAS Doctor

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The Professional SAS Doctor

• Dr Maire Shelly
• Associate Postgraduate Dean
• North Western Deanery

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Welcome
Why are you here?
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What is Medical Professionalism?
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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 patient-centred professionalism.
• Picker Institute

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Medical Professionalism - Definition

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

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Medical Professionalism - Description

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

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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

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Good Medical Practice

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

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NCAS Professional Domains

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

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How do I recognise professional values in
practice?
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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?
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Professionalism

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

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How do I demonstrate my professional values?
What else will I do?
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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