While the concept of medical professionalism can be traced back to the guild system of medieval Europe, Thomas Percival’s Medical Ethics from the early 1900s was the first to describe medicine as a “profession” and as a “public trust.” Public response to this concept has varied over the centuries – from distrust to acceptance. However, given recent concerns over declining public trust in health care as a whole, there has been a push by many in the medical profession, including the ACC, to reaffirm the importance of professionalism. Over the last several years the ACC has unanimously ratified and approved the adoption of the “Medical Professionalism in the New Millennium: A Physician Charter.” This charter, originally published in The Lancet and Annals of Internal Medicine in 2002, is the standard for a document expressing the tenets of medical professionalism and has been adopted by more than 100 medical societies and medical specialty societies around the world. The College has also developed educational programs and tools to help inform the next generation of cardiovascular professionals about the importance of professionalism, which according to Chittur A. Sivaram, MBBS, FACC, immediate past chair of the College’s Cardiovascular Training Section, is no easy task. “Professionalism is not an easy subject to teach – it is inherently a dry subject for medical school faculty due to the heavy bias in medical education towards scientific materials,” he says. “This is compounded also by the inherent difficulty in moving professionalism from the abstract to observable, discrete behaviors, a feature that medical educators focus upon.” Mentoring and leadership programs, a special Intensive Program focused on the topic at ACC.16 in Chicago, and ongoing development of Appropriate Use Criteria, clinical guidelines and clinical documents like the “2016 ACC Lifelong Learning Competencies for General Cardiologists” – all are focused on helping cardiovascular professionals understand and value professionalism. The College’s new Medical Professionalism Maintenance of Certification (MOC) module is also gaining traction among ACC members, as well as externally with nearly 30 other medical specialty societies. The free, online module allows participants to earn 10 MOC points by answering 30 multiple-choice questions on the topic of medical professionalism, including integrity and accountability, fair and ethical use of health care resources, self-regulation and commitment to excellence. “The ACC module bridges the gap between the abstract to observable very effectively,” says Sivaram. “It is effective because it provides focused commentaries and scenarios on special and practical aspects of professionalism as they apply to the current era.” Shashank S. Sinha, MD, chair of ACC’s Fellows in Training Section, agrees. “While I occasionally still hear from faculty and colleagues that professionalism is a static characteristic of an individual, most now embrace that professionalism is a multidimensional competency encompassing a series of behaviors and skills that can be learned and practiced over the course of our training and career,” he says. “This module provides an excellent foundation to assimilating those skills and behaviors.” Sinha notes that the module is most valuable for those that think of professionalism as a competency that doesn’t necessarily have to be learned and practiced. “When you’re in training and you’re tired and sleep-deprived and have to make decisions and work with others as a team to make decisions, this is precisely when practiced professionalism is most needed,” he says. Professional Life Survey Says … Female cardiologists remain underrepresented in the field, comprising less than 20 percent of cardiologists who see adult patients, according to results from ACC’s third professional life survey presented at ACC.16 in Chicago. Additionally, women may be less likely than their male counterparts to get married and have children and may be more likely to face challenges related to child care, family leave policies and professional discrimination. The study, led by Sandra J. Lewis, MD, FACC, chair of ACC’s Women in Cardiology Section, looked at results from ACC’s 2015 professional life survey – which examined cardiologists’ career decisions, family life and satisfaction by gender – and compared data to two previous surveys from 1996 and 2006. Out of the more than 2,000 cardiologists who completed the 2015 survey, results showed that women make up half of all medical school graduates and nearly half of internal medicine specialists, yet they represent less than one-fifth of adult cardiologists. The survey also found that while most cardiologists of both genders report overall satisfaction with their careers, women are more likely to say their level of professional advancement is lower than their peers. Sixty-three percent of women report experiencing past discrimination, such as receiving a lower salary or being passed up for promotion. That proportion is significantly down from 71 percent and 69 percent in 1996 and 2006, respectively, but still substantially higher than the rates reported by men. “I’m very concerned that we haven’t seen much growth in the number of women in adult cardiology,” says Lewis. “We need to understand the barriers to women entering cardiology and work toward breaking down those barriers.”
Published by American College of Cardiology. View All Articles.
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