Medical professionalism is under threat, say eight in 10 aspiring Brit
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《英国医生杂志》
Most trainee doctors and medical students in the United Kingdom believe that high public expectations of what medicine can do and too many targets in the health service are reducing doctors?autonomy and will drive colleagues out of the profession, a survey has found.
The survey of more than 2000 trainee doctors and medical students, which was carried out by the trainees committee of the Royal College of Physicians, found that eight out of 10 respondents thought medical professionalism to be under threat and that external factors were largely to blame.
Pressure on doctors from the public and politicians to deliver ever higher quality care within a limited budget, together with increasingly protocol driven care, was having a detrimental effect on the values that trainee doctors regard as defining their profession and that they hold most dear, the survey shows.
These values include qualities such as altruism and humility, which respondents say underpin an effective doctor-patient relationship. Changes in working patterns and medical education were also judged to be undermining medical professionalism.
Almost all respondents to the survey (97%) agreed that the purpose of medical professionalism was to maintain or improve the care of patients. The qualities of the profession, including autonomy and patient focused care, are learnt through apprenticeship and lead to good clinical care, believe the trainees.
But the increase in clinicians?responsibilities over the past five years has led to a decrease in their autonomy, say 83% of the respondents.
Declan Chard, chairman of the trainees committee, said: "Junior doctors and medical students believe that professionalism is not optional but an essential part of being a doctor; it is at the core of our relationship with patients.
"Sadly, many trainees believe that medical professionalism is being challenged to a degree that they may consider leaving medicine; ultimately this will have a negative effect on patient care. If the NHS hopes to retain its doctors and fully support them in their work, it should more overtly value medical professionalism."
A working party report on medical professionalism from the Royal College of Physicians is being launched next week.(London Zosia Kmietowicz)
The survey of more than 2000 trainee doctors and medical students, which was carried out by the trainees committee of the Royal College of Physicians, found that eight out of 10 respondents thought medical professionalism to be under threat and that external factors were largely to blame.
Pressure on doctors from the public and politicians to deliver ever higher quality care within a limited budget, together with increasingly protocol driven care, was having a detrimental effect on the values that trainee doctors regard as defining their profession and that they hold most dear, the survey shows.
These values include qualities such as altruism and humility, which respondents say underpin an effective doctor-patient relationship. Changes in working patterns and medical education were also judged to be undermining medical professionalism.
Almost all respondents to the survey (97%) agreed that the purpose of medical professionalism was to maintain or improve the care of patients. The qualities of the profession, including autonomy and patient focused care, are learnt through apprenticeship and lead to good clinical care, believe the trainees.
But the increase in clinicians?responsibilities over the past five years has led to a decrease in their autonomy, say 83% of the respondents.
Declan Chard, chairman of the trainees committee, said: "Junior doctors and medical students believe that professionalism is not optional but an essential part of being a doctor; it is at the core of our relationship with patients.
"Sadly, many trainees believe that medical professionalism is being challenged to a degree that they may consider leaving medicine; ultimately this will have a negative effect on patient care. If the NHS hopes to retain its doctors and fully support them in their work, it should more overtly value medical professionalism."
A working party report on medical professionalism from the Royal College of Physicians is being launched next week.(London Zosia Kmietowicz)