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.
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:
Can we teach empathy at Med School?
Consolation reduces stress, funny video
Patient doctor relationship: Self-Disclosure
Goldberg, J.L. (2008). Humanism or Professionalism? The White
Coat Ceremony and Medical Education. Academic Medicine, 83, 715-722.
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I think “semiautonomous minisociety” is a false premise. A profession is self-evidently a subset of society as a whole, and professionals are both individually and collectively bound by their wider society’s rules and values.
The binding is dynamic, so that at any moment in time there exist some contentious issues that are in the process of being resolved. The resolution is invariably that wider society imposes its rules and values on the profession, not the other way around. Aggressive commercialism is an example of that.
I also think that “professionalism embodies humanism” is a straw man. Professionals employ heuristics to achieve some humanist aims, but that does not give professionals ownership of humanism in general. Professionalism operates within the narrow confines of each profession, while humanism operates at large — within every profession and in areas that belong to no profession. So, again self-evidently, humanism embodies professionalism.
For such a fine-sounding conclusion, “our goal is physicians who see their medicine as part of a commitment to humanism,” the arguments here seem flimsy. Promoting the idea that professionalism has a flimsy basis can only help to undermine the professions, making that goal more distant.
In an ideal world I would agree with you that humanism embodies professionalism. Unfortunately professionals often work in their own world not tuning in on changing values and attitudes of the world around them.
This not only applies to medical professionals but also to other professionals in which communication with lay persons is of importance such as the police and government officials.
Regards Dr Shock
I think this may be a little over my head, but I want to share my thoughts regardless. With the experience I just had with 12 ECT treatments, I was and am very impressed with DR. V and his staff. It seems, if I understand correctly, that they walked in a fine balance of humanism and professionalism. The encouragement I received when I was afraid to continue made me feel like I wasn’t alone in wanting to quit treatment and that I could overcome my fear and complete it. Also,, the simplest action from his staff of saying, “Hey Kara” every time I came for treatment really showed me that it was more than just a job to them. So, it appeared they were professional and caring at the same time.
It is an excellent example of professionals doing their job very well. Thanks for sharing, regards Dr Shock
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Hey DR SHOCK, it is very important to impinge humanism in medical school curriculum.