Symposia

Professionalism — The Critical Element in Health Care Education

If doctors falter in their professionalism, health care reform efforts will come up short, said Jordan Cohen, M.D., president emeritus of the Association of the American Medical Colleges and professor of medicine and public health at George Washington University.

"Professionalism is when physicians know the right thing to do and then do it," he remarked in his keynote luncheon address. "It's the behavior required of doctors in fulfilling their compact with society. They are honor bound on their own volition to work in patients' best interest and use their knowledge and expertise to that end."

Dr. Cohen said that nurturing professionalism is one way to advance needed changes in U.S. health care, and he recommended six ways for educators to promote professionalism:

• Adopt and approve admission criteria. Few medical students fail to graduate and fewer still fail to get licensed. Educators have a fundamental role as gatekeepers to the profession.
• Establish explicit learning objectives. Adults learn best when they have prospective understanding of what they are going to learn.
• Address the rationale for adhering to the precepts of professionalism in the formal curriculum. Future physicians need to be mindful of temptations and ways to withstand conflicts of interest.
• Be proactive and intentional in the informal curriculum. Educators need to model behaviors emblematic of professionalism. Informal curriculum is one of the most powerful influences on adopting the norms of the profession.
• Articulate institutional expectations. "We need to be unabashed about communicating these expectations," says Dr. Cohen.
• Evaluate and reward behaviors that are emblematic of professionalism. Sanction and call out those who are not professional.

Americans long to trust their physicians and polls show that they largely do, Dr. Cohen added. And, trusting doctors is good for patients. "It increasing compliance and improves outcomes," he remarked. "But that trust is earned, not owed. The surest way to lose that trust is to abandon professionalism."