Common issues in medical professionalism: Room to grow

PURPOSE: Much of the respect and trust that society grants to physicians is based an the expectation of upholding professional values. We performed th is study to assess responses to common challenges to medical professionalis m and to ascertain physician satisfaction with training in professionalism. METHODS: A self-administered questionnaire containing six challenges to pro fessionalism (acceptance of gifts, conflict of interest, confidentiality, p hysician impairment, sexual harassment, and honesty) with multiple-choice r esponses was mailed to 528 medical students and 779 house officers at the U niversity of Colorado Health Sciences Center and to 900 randomly selected C olorado physicians. Information about previous exposure to the issue depict ed in the scenarios and satisfaction with, and site of, previous education in medical professionalism was obtained. An independent panel selected the best or acceptable answers to the challenges. RESULTS: In all, 961 evaluable responses were received. More than 40% of ph ysicians reported experience with four of the six challenges. The frequency of the best or acceptable answers to the six scenarios ranged from 12% to 86%. Best or acceptable responses were more common in physicians than in ho use officers, and in house officers than in medical students (P <0.001). pr actice setting and specialty type had only modest effects. The physician im pairment scenario was the most challenging: Only 12% of physicians provided the best answer. Most (73%) respondents reported having 10 or fewer hours of formal course work in professionalism, and many (40%) were dissatisfied with their training in professionalism. CONCLUSIONS: While everyday challenges to professionalism are commonly enco untered by trainees and practicing physicians, many practitioners are dissa tisfied with their training in this area and were unable to provide an acce ptable answer to these challenges. (C) 2000 by Excerpta Medica, Inc.