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High standards essential to sustaining patient trust

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There is no professional relationship where trust is more intrinsic than the doctor-patient relationship.

Patients trust us when they are at their most vulnerable – when they are sick, hurt, confused, scared, when they are born, when they are dying. They trust us to care not only for them, but for their loved ones, to treat their bodies and their minds, to be honest, to be respectful, to protect their confidentiality, to put their health needs first.

If people do not trust doctors, they may seek care elsewhere, or not seek care at all – outcomes which may prove detrimental not only to their own health, but the wellbeing of the wider public.

The success of the doctor-patient relationship, as well as the wider profession-society relationship, depends on trust, which can be maintained through a strong adherence to medical professionalism.

Medical professionalism refers to the values and skills that the profession and society expects of individual doctors and the medical profession, encapsulating both the doctor-patient relationship and the wider ‘social contract’ between the profession and society.

Individual doctors are expected to uphold the core values of the medical profession such as respect, trust, compassion, altruism, integrity, advocacy and leadership, collegiality (among others).

The medical profession is expected to adhere to the social contract with society. The profession is granted a high level of autonomy and clinical independence because society values the profession’s highly specialised knowledge and skills in serving the public interest.

In return for this relative autonomy and independence, the medical profession is expected to use its unique expertise to set and maintain high standards of ethics, practice, competency and conduct through an open and accountable process of profession-led regulation.

More than anything, medical professionalism encapsulates the profession’s commitment to prioritise patient interests above all else.

But our ability to appropriately care and advocate for our patients is increasingly challenged by today’s often chaotic and demanding health care system.

We work in an environment of mounting costs; increasing bureaucracy, managerialism and regulation; changes to the structure and funding of the workforce; rising consumerism; and shifting perceptions of the medical profession.

While such issues may prove frustrating, demoralising, or even overwhelming at times, they should never undermine or compromise our commitment to our patients and the values of medical professionalism.

Through leadership, unity, solidarity and collegiality, the medical profession should adhere to and promote the values of medical professionalism to its own members, from medical students through to retiring doctors, from doctors who work in clinical practice to those who work in research, academia and administration. These qualities are fundamental to quality medical care.

*The AMA’s Position Statement on Medical Professionalism 2010 has been revised as part of the five year position statement review cycle. The Position Statement defines medical professionalism, sets out the core values of the profession and acknowledges the challenges that the modern, dynamic health care environment poses to putting patients’ interests first.