Patient Doctor Relationship: Humanism and Medical Professionalism

A young caring doctor

The opinion that humanism and professionalism are one and the same carries the risk of isolating the physician from the lay public.

What is humanism in the medical profession?

The accordance of deep respect to humans individually, and to humanity collectively, and concern for their general welfare and flourishing

In other words it is taking care of all humans equally with humanity based on the most part by experience and aimed at human welfare.

What is professionalism?

a group of specialized workers whose expert knowledge earns them the right to function independently as a semiautonomous minisociety. The strength of a profession as a social unit lies in its members’ assertion of a distinct and consolidated collective identity, whether through participation in professional organizations; the nurturing of a rich, internal professional culture; or censure of those who deviate from the profession’s standards of conduct

Humanism and professionalism have some common ground especially in the patient doctor interaction. The overlap is in the empathy, compassion, respect, integrity in the patient doctor relationship. These could easily be described as components of both professionalism and humanism.

In a recent article in Academic Medicine the relationship between humanism and professionalism is discussed. The author has a strong point of view on this subject. According to the author the notion that professionalism embodies humanism is wrong and it robs us from “an important reality check that can keep us grounded in and connected to the lay population we serve”.

Besides more general differences between humanism and professionalism as can be seen in the next table, other differences are emphasised in this article.

Humanism and Professionalism, differences

Examples of cultural components subject to discussion and justified by tradition:

  • certain standards of the appropriate dress, demeanor, language, and habits of a physician
  • a level of comfort in trespassing usual social taboos of exposing and touching strangers
  • a readiness to blend patient care with student mentoring in clinical contexts
  • a tacit understanding of the limits of physician responsibility
  • a vision of medicine as an essentially scientific field

Why is it important?
The most important point that is being made in this article is that professionalism carries the risk of isolating the physician from the lay public. Another reason why as an educator I stimulate residents to have a life next to their professional life. Moreover, the tension between adapting to a new professional identity and the lay position is most visible and even palpable during clerkship and residency training.

The more common view that is held by educators is that humanism and professionalism are fully overlapping, complementary. The danger in this is the blind eye for tension or contradictions between physician practice and patient perception. The danger of isolating the physician from the lay public.

Another striking example made by the author of the tension between professionalism and humanism is the tolerance of an increasingly aggressive commercialism among physicians, especially of ever-closer financial ties to the pharmaceutical industry. If humanism is one with professionalism than why the public outrage in these cases and the hush hush reactions by some professionals?

Not that professionalism is wrong on the contrary, but it is not the only point of view. Or as the author put it

Let them learn to subordinate their medical, professional identity to their
essential human character, for our goal is physicians who see their medicine as part of a commitment to humanism, not physicians who superficially incorporate values of humanism into their picture of medicine.

I think he has a point, let me know what you think.

Other recent posts in the series: Patient Doctor Relationship:

Neuroscience of empathy

Empathy

Can we teach empathy at Med School?

Consolation reduces stress, funny video

Patient doctor relationship: Self-Disclosure


Emotional Intelligence

ResearchBlogging.org
Goldberg, J.L. (2008). Humanism or Professionalism? The White
Coat Ceremony and Medical Education. Academic Medicine, 83, 715-722.