Rhiannon Barker is Head of Business Development at the Point of Care Foundation (POCF). Here she shares her thoughts about the Medical professionalism matters event in Manchester: ‘identifying sustainable solutions for the profession in the 21st century’.
To kick off the debate the audience, made up predominantly of clinicians, were asked to respond to a few themed questions. Whilst 63% thought that doctors remain deeply motivated by compassion it appears that some may be hampered by a culture that lacks the will to learn from mistakes; only 43% of the audience were confident that they would be supported in raising concerns.
The concept of medical professionalism is difficult to define and open to a myriad of definitions and interpretations. Prof Jacky Hayden, Dean of Postgraduate Medical Studies at Health Education North West, suggested that key generic professional capabilities include:
Missing from this list perhaps are compassionate communication, collaborative team work, and the capacity for self-care – capabilities that were all explored in table top discussions. These relational characteristics reside in the individual but are supported and enhanced by the organisational environment. Barriers to enabling them to flourish were a common theme. I joined a table discussion on ‘the resilient doctor’ in which there was strong agreement that having more time for reflection would contribute to coherent teams and thus better engagement – yet the time and resource needed to bring about safe space which would allow for this, often remains elusive. The doctors in my group were clear that to support patients with compassion they needed to give of themselves – yet to do this they need the capacity to care for themselves.
It is the unique relationship between doctor and patient that is the motivation for many aspirational students to enter the medical profession. This relationship works in two directions with patients benefiting from high standards of professionalism from the doctor – but the doctor is also rewarded by feeling that their input has had a positive impact on the individual they are working with. Yet knowing how best to spread the scare resource (particularly in relation to their time) is a constant source of stress.
The discussion on ‘the doctor’s dilemma’ table looked at the role of doctor as advocate, with one doctor expressing her commitment to working with vulnerable groups who can’t easily articulate their needs. The eloquent middle classes she reasoned, tend to be more successful at achieving the medical attention they demand, whilst those lower down the socio-economic hierarchy – the elderly, those living in poverty or from marginalised groups – are often less able to identify and pursue the services from which they may benefit. A fascinating discussion developed – around the pros and cons of the role of doctors as advocate for individuals or communities. The doctor at my table, who had spent years advocating and supporting vulnerable individuals in her practice admitted that such behaviours were not sustainable and came with a high risk of burnout.
The key message I took away from the event is that the 78% of doctors who believe that they are so busy looking after others that they neglect themselves should now be listened to and this problem addressed. A resilient doctor is a rested doctor – a doctor with the energy to value building collaborative supportive relationships with the team that will in turn collectively be able to face patients with humanity and compassion. Resilience is not about the ability to endure – but about finding ways of protecting time and space to build supportive relationships.
Developed from the work carried out through the Point of Care programme at The King’s Fund (2007-2013), The Point of Care Foundation’s mission is to humanise healthcare. The Foundation has unique experience in driving up professional standards, helping to build compassionate organisations and transforming the way that care is delivered in the UK.