'Doctors in Society: Medical professionalism in a changing world' is the most far reaching College report of recent years. It sees the values of medical professionalism as fundamental not only to the integrity of the doctor-patient partnership but also to the roles of doctors in the life of our society. Under six main themes - leadership, teams, education, appraisal, careers and research - the report makes clear, practical recommendations that will lead not only to further improvements in patient care, but also offer more challenging and fulfilling lives for doctors. It recommends:
- Strengthening leadership and managerial skills
- Developing clinical leaders
- Creating a national voice for medicine
- Better interprofessional education and training
- Identifying potential medical students with developed, or the potential to develop, the qualities of medical professionalism
- Education, training and evaluation of medical professionalism throughout a doctor's career
- Managing medical careers more effectively, particularly through the use of mentorship to transmit professional values
Doctors are asked to recognise themselves as role models, and to assess their values, behaviours and relationships against the working party's description, taking responsibility for meeting this aspirational standard.
The College and the organisations in the report charged with recommendations will take the work forward into 2006 and beyond. One of the major tasks will be creating (or recreating) environments in which professionalism can flourish.
Professor Wass said: "Students studying medicine in the 21st Century live in a different society from that in which their teachers trained. This most welcome report highlights the need for medical schools to prepare and instill in our future doctors professional values of the highest standard, appropriate to the needs of this changing society."
Baroness Julia Cumberlege, Chair of the working party, said: "Deference is dead. In the modern world patients want a more equal relationship with their doctor. The internet supplies a wealth of information, not always accurate; science provides new technologies, sometimes potentially dangerous; management monitors and expects results in productivity, on occasions engendering unavoidable conflict.
"By strengthening and developing medical professionalism doctors can respond to a myriad of pressures and meet new challenges which emerge, while maintaining the trust the public has in the profession."
Professor Dame Carol Black, RCP President, said: "This report presents a new approach to building a strengthened form of medical professionalism, valid for our time, to maintain trust and confidence in doctors and their partnership in our system of healthcare. It gives fresh emphasis to qualities that should endure, brings in new ones that reflect the needs and aspirations of a modern society, and discards those that are now obsolete."
Dr Richard Horton, report author, said: "Every doctor knows that professionalism is medicine's most precious commodity. It is a critical but neglected aspect of patient care – neglected not only by government but also by some medical institutions. Misunderstandings about professionalism lie at the heart of much disquiet over the government's vision for a "patient-led NHS". Professionalism is currently being jeopardised by a political culture that is hostile to the fundamental values, behaviours, and relationships that are essential for good medical practice."
Mr Bob Nicholls, non-medical member of the working party, said: "As a patient or carer my confidence in doctors derives from the professional behaviours set out in the report, not their contract of employment"
Why was this working party necessary?
The roles and responsibilities of doctors were no longer clear in a changing environment, where social and political factors, and advances in clinical practice have reshaped attitudes and expectations both of the public and doctors. Events such as Shipman, Alder Hey, and Bristol have undermined public trust in medicine, and recent reorganisations of medical training and work patterns have contributed to a perceived decrease in autonomy and more fragmented patient care.
In this context, the working party sought to define a new, strengthened form of medical professionalism to maintain trust and confidence in doctors, whose prime goal is to serve patients well.
Gathering the evidence
From October 2004 until June 2005, the working party took oral evidence from 20 witnesses, received over 100 written responses to a set of questions about medical professionalism, commissioned a questionnaire and focus groups, drew on peer-reviewed literature and medical and lay opinion. The Technical Supplement to the report will be published separately. Many key figures from medical, professional and public life spared valuable time to contribute, and are quoted throughout the report.
Notes to Editors
The report and technical supplement will be published on the RCP website at 10.00 am on Tuesday 6 December. Members of the working party will be available for interview at various times over the 6th and 7th December.
The report will be launched at a press conference at the Institute of Mechanical Engineers, One Birdcage Walk, Westminster on Tuesday 6 December at 10.00 am.
The University of Manchester (www.manchester.ac.uk) is the largest higher education institution in the country, with 24 academic schools and over 36 000 students in 2005/6. Its Faculty of Medical & Human Sciences (www.mhs.manchester.ac.uk) is one of the largest faculties of clinical and health sciences in Europe, with a research income of around £51 million, and the School of Medicine (www.medicine.manchester.ac.uk) is the largest of the its five Schools. It encompasses five teaching hospitals, and is closely linked to general hospitals and community practices across the North West of England.
For further information please contact:
The University of Manchester Press Office: Jo Nightingale on 0161 275 8156/joanne.nightingale@manchester.ac.uk or Mikaela Sitford on 0161 275 2111/mikaela.sitford@manchester.ac.uk.