{"id":997,"date":"2010-02-17T09:39:01","date_gmt":"2010-02-17T08:39:01","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=997"},"modified":"2010-02-23T11:19:56","modified_gmt":"2010-02-23T10:19:56","slug":"helen-jaques-asks-what-makes-a-good-doctor","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2010\/02\/17\/helen-jaques-asks-what-makes-a-good-doctor\/","title":{"rendered":"Helen Jaques asks what makes a good doctor?"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/columns\/icons\/helen_jaques.jpg\" alt=\"Helen Jaques\" width=\"160\" height=\"110\" align=\"left\" \/>Back in 2006 the <a href=\"http:\/\/www.bma.org.uk\/\">British Medical Association<\/a> asked <a href=\"http:\/\/www.bma.org.uk\/healthcare_policy\/cohort_studies\/cohortprofvalues.jsp\">almost 1,000 doctors<\/a> what core professional values were most important for the practice of medicine, and the respondents came up with <a href=\"http:\/\/www.bmj.com\/cgi\/content\/full\/336\/7649\/0\">all the \u201cC\u201ds<\/a>: competence, caring, compassion, and commitment.<\/p>\n<p>According to a new study in the <a href=\"http:\/\/jme.bmj.com\/\">Journal of Medical Ethics<\/a>, however, another \u201cC\u201d needs to be added to the list: cheerfulness.<!--more--><\/p>\n<p><a href=\"http:\/\/www.chambersharrap.co.uk\/chambers\/features\/chref\/chref.py\/main?query=geniality&amp;title=21st\">Geniality<\/a>\u2014being cheerful, friendly, or sociable\u2014came out as the top attribute of a good physician in a study of <a href=\"http:\/\/jme.bmj.com\/content\/36\/2\/121.abstract\">more than 100 Turkish medical students<\/a>. On the other hand, traits covering scientific knowledge and medical practice\u2014such as professional competence and perseverance\u2014came out bottom.<\/p>\n<p>The authors of this study asked a group of 127 first year medical students to write down and discuss the \u201cattributes of a good physician.\u201d The students came up with a total of 756 attributes, which were then grouped into four broad categories.<\/p>\n<p>The \u201cinterpersonal relations and communication\u201d category had the most entries (n=413 (54.6%)), with the individual traits of geniality, being able to communicate well, humaneness\u2014\u201ctreating patients as human beings not as robots of pieces of meat,\u201d said one student\u2014and benevolence being the top four characteristics overall.<\/p>\n<p>The category \u201csustaining professional integrity,\u201d such as by \u201cbehaving in a way that inspires respect for the profession\u201d and \u201ctreating everyone equally,\u201d had the next highest number of entries (n=133 (17.6%)), whereas the \u201csustaining personal integrity\u201d category, which included the ethereal concept of \u201cbeing a good person,\u201d was third (n=112 (15.5%).<\/p>\n<p>Surprisingly, \u201cscientific knowledge and medical practice\u201d category had the least number of entries (n=98 (12.3%)), although open-mindedness was 8th most popular trait overall. Being \u201chardworking,\u201d \u201cable to think scientifically,\u201d or \u201cclever\u201d were each mentioned by fewer than 10 students.<\/p>\n<p>A similar study carried out with faculty, residents, medical students, and patients in the departments of family medicine and paediatrics of a hospital in the US state of Georgia found that compassion was the top \u201ccharacter virtue\u201d expected of doctors.<\/p>\n<p>The other two big areas necessary to maintain professionalism were \u201cknowledge\/technical skills\u201d\u2014being \u201cup to date\u201d and \u201cknowing their stuff\u201d\u2014and \u201cpatient relationship\u201d\u2014\u201ctreating people the way you want to be treated.\u201d<\/p>\n<p>Although both the Turkish and the US study found that communication was valued highly, the US participants didn\u2019t mention social justice, whereas the Turkish students placed great emphasis on being fair.<\/p>\n<p>But why are people so concerned about the personality attributes of doctors? Well, compared with other professionals, doctors have a quite unique relationship with their \u201ccustomers\u201d\u2014their patients.<\/p>\n<p>As the Royal College of Physician\u2019s report <a href=\"http:\/\/www.rcplondon.ac.uk\/pubs\/contents\/f6ac2ea5-9ad2-4e74-b7d2-81934ad1852e.pdf\"><em>Doctors in society: Medical professionalism in a changing world<\/em> <\/a>points out, \u201cMedicine concerns the experiences, feelings, and interpretations of human beings in often extraordinary moments of fear, anxiety, and doubt. In this extremely vulnerable position, it is medical professionalism that underpins the trust the public has in doctors.\u201d<\/p>\n<p>So what does this mean for doctors? Can these personality characteristics be instilled throughout the course of medical training, or, as one of the participants in the Georgia study said, \u201cyou can dress people up, but you can\u2019t make everyone a doctor\u201d?<\/p>\n<p>Medical educators prefer to go with the latter, and much effort has gone into trying to pinpoint the core characteristics that make someone a good doctor and instil said values into medical students. Medical bodies such as the <a href=\"http:\/\/www.rcplondon.ac.uk\/pubs\/brochure.aspx?e=75\">Royal College of Physicians<\/a> and the <a href=\"http:\/\/www.gmc-uk.org\/guidance\/good_medical_practice.asp\">General Medical Council<\/a>, for example, have analysed the importance of the behaviour of doctors in countless working groups and reports on professionalism.<\/p>\n<p>Luckily most of the characteristics highlighted by the Turkish medical students link well to the <a href=\"http:\/\/www.acgme.org\/outcome\/comp\/GeneralCompetenciesStandards21307.pdf\">objectives in the Turkish medical school curriculum<\/a> and the <a href=\"https:\/\/services.aamc.org\/publications\/showfile.cfm?file=version87.pdf&amp;prd_id=198&amp;prv_id=239&amp;pdf_id=87\">learning objectives for medical education<\/a> from the <a href=\"http:\/\/www.aamc.org\/\">Association of American Medical Colleges<\/a>, so it seems that the efforts to instil professional values seem to have worked pretty well in this bunch of undergraduates.<\/p>\n<p>\u2022\u00a0For more on teaching and measuring professionalism, see:<br \/>\nEngel N, Dmetrichuk J, Shanks AM. <a href=\"http:\/\/student.bmj.com\/student\/view-article.html?id=sbmj.b4455\">Medical professionalism: Can it and should it be measured?<\/a> <em>Student BMJ<\/em> 2009;17:b4455<\/p>\n<p><em><strong>Helen Jaques<\/strong> is a technical editor for the BMJ<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Back in 2006 the British Medical Association asked almost 1,000 doctors what core professional values were most important for the practice of medicine, and the respondents came up with all [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2010\/02\/17\/helen-jaques-asks-what-makes-a-good-doctor\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":66,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[116],"tags":[],"class_list":["post-997","post","type-post","status-publish","format-standard","hentry","category-editors-at-large"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Helen Jaques asks what makes a good doctor? 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