Doctors feel cut off from professionalism debate

April 26, 2007

Doctors are pessimistic about professionalism and feel dangerously disengaged and alienated from debates on the subject, says a Comment in this week's edition of The Lancet.

The comment was authored by Richard Horton (editor, The Lancet), Ian Gilmore (president, Royal College of Physicians), Sue Shepherd (president's office, Royal College of Physicians) Niall Dickson (chief executive, The King's Fund) and Steve Dewar (director, funding and development, The King's Fund)

It says the fiasco of Modernising Medical Careers, the paralysis of Connecting for Health, and the rhetoric of patients' choice - all initiatives launched with large and loud claims - have slid into disrepute and left health workers of all levels demoralised.

But the Comment adds that lessons are starting to be learnt from Royal College of Physicians' two year inquiry into the state of medical professionalism.

The inquiry examined the professional values of leadership, team working, education, appraisal, careers and research, and went on to make a range of recommendations affecting the General Medical Council, the Royal Colleges and Academy of Medical Royal Colleges, medical schools, the British Medical Association, the Department of Health, research funding bodies, and individual doctors themselves.

Despite the criticism from the inquiry, the Royal College of Physicians remained upbeat and arranged a series of 'professionalism roadshows' around England and Wales throughout 2006 and 2007 to discuss the inquiry and the King's Fund's view of medical professionalism.

And not only doctors, but health professionals, medical students, and patients representatives also attended - an unusually diverse cross section for a college led event.

The Comment stresses the importance of working in a different way which was championed in the roadshows - working not as discrete professional groups, but as cross-disciplinary teams, including managers, students, patients and the public.

The comment says: "This spirit must be amplified across the health service."

It concludes: "Although it is too early to tell whether measurable systemic change has taken place, we can safely conclude that medical professionalism is now back on the political map of UK health. It is up to the professions to make something of that success, for the benefit of both patients care' and the long-term future of the NHS."


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