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It may help us to understand our core role as doctors if we understand and accept the responsibilities that come from being a member of a “profession.”1 The definition and concept I relate to was expressed by John K Davies back in 1991.2
He thinks a professional’s duty is not primarily to please but to do or advise the “right” thing. Usually, this pleases as well as alleviating the problem, but what is said or advised may not be what the patient wants to hear. The integrity of the doctor and what gives him or her professional status is the willingness and ability to take a difficult or unpopular stance because he or she knows, in good faith and not paternalistically, that this is the best advice, informed by up to date knowledge and opinion.
Doctors are in a privileged position, and the concept of professionalism described above is perhaps subconsciously recognised by society in awarding that privilege. With that privilege comes a responsibility to always act professionally by being well informed and being able and prepared to provide “tough love” if necessary. In my opinion, we are prepared to do this because we care.
The irreducible core value of a doctor is that he or she cares for the wellbeing of his or her patients. Our purpose for practising medicine is in danger of being lost if we cannot undertake this role because of management and professional practices that emphasise process and productivity. If doctors cannot satisfactorily care for their patients then their reason to remain in the profession and maintain the required standards will be lost, leading to disillusionment and perhaps the loss of morale we see at present.
Competing interests: None declared.