The Professionalism Committee - Letter to SSOM Colleagues

Letter to SSOM Colleagues

Dear Colleague:

We write to ask your support and participation in fostering a more professionally supportive environment at Stritch School of Medicine (SSOM). Dr. Myles Sheehan, Senior Associate Dean, appointed us to an ad hoc committee of faculty, students, and administrators, and asked us to examine how we might facilitate professional behavior among our students. Our discussions have led to the inescapable conclusion that engaging the larger Loyola University Medical Center (LUMC) community is critical to these goals. We must achieve the vision of Loyola as a unique environment that supports professional growth and behavior, with expectations that are shared and celebrated among all of us, including medical and basic science faculty, resident physicians, other health-care professionals, and administrators.

The purpose of this letter is to share our recommendations and suggestions for implementation and to invite you to participate in a dialogue concerning professionalism on our campus. We believe that fostering professionalism is a responsibility that all concerned with justice will welcome. The current health-care climate exerts a variety of financial pressures on physicians, their co-workers, and the institutions that train them that can dehumanize the art of medicine. Today's health-care professionals face the challenges of: treating more patients in less time; curtailments in or denial of reimbursement for care; and offers of bonuses, grants, and gifts that can cloud judgment as to what is truly in the patient's best interests. Professionalism is the state of character that habitually asserts the primacy of the patient's interests in the face of such obstacles and remains proactive in contributing to the common good.

Professionalism within the Loyola University Medical Center community is intrinsically linked to the values of our campus's Jesuit and Catholic heritage. Professionalism at LUMC is characterized by a dedication to serve those most in need and a recognition of the importance of mercy and forgiveness within a framework of mutual respect, education, growth, and measured corrective response. Our philosophy counsels rewarding effort and excellence and provision of formative, not punitive, feedback. We have found much to celebrate at Loyola in all of the areas we have studied, suggesting that a strong commitment to professionalism already exists We believe that these strengths can be enhanced by inclusive discussions, clarification of expectations, and sustained reflection among the members of the Loyola community.

Our specific recommendations to Dean Sheehan include the following.

A climate of self- and peer-regulation should be fostered among the medical students. This is important in preparing for a vocation that relies heavily on professional standards and peer-review. The implementation of a self-generated student statement regarding professional and ethical behavior, one that includes ongoing peer evaluation, may help students to see that their character is the most important outcome of the rigorous program of study of their first two years of professional training. A preliminary statement of this type has been drafted by the student members of our committee in consultation with Associate Dean Theresa Wronski.
The climate of professionalism needs to be enhanced in the clinical training of the medical students. Expectations of professional behavior should be explicitly articulated by clinical mentors and evaluated by all to whom physicians are accountable including mentors, peers, nurses and professionals of all health-care disciplines, and patients and their families. Educational activities that foster this climate should be devised and incorporated into each clerkship. These programs would best be designed and implemented by the faculty of each department.
The positive role modeling behavior of residents and faculty should be explicitly recognized. Similarly, effective and realistic mechanisms for constructive feedback regarding the unprofessional behaviors of residents and faculty must be developed. The culture and values of professional self-regulation will only be taken seriously by medical students if their role models incorporate them as a routine part of their clinical teaching and practice.
Means of recognizing and reinforcing the positive leadership aspects of our students and faculty should be accentuated. For instance, SSOM students are often distinguished by their substantial voluntary service efforts. A method of tracking and reflecting on these endeavors with mentors and other members of the professional community would likely reinforce and expand these signature programs.
The goals of self-reflection and role modeling of professionalism can be enhanced through a professionalism portfolio assessment. Students should set personal goals related to each area of professionalism, e.g., service, appropriate interaction with mentors, peers, patients, and others, and reflect periodically upon their progress toward their goals. Their faculty advisors should also undertake this exercise to role model its importance and make explicit their ongoing professional development.
A mechanism should be implemented that affords students a safe environment to discuss issues of mistreatment and learn strategies for coping with unprofessional behavior. These mechanisms should also provide students representation and advocacy when pursuing remedies for egregious mistreatment.
We hope that committees or working groups on professionalism will be formed among the other disciplines such as nursing, social work, and health-care administration. These disciplines aim at the common end of patient care as well. They must be invited to dialogue with the faculty physicians, residents, and medical students in order to increase cooperation.

Articulation of the specific recommendations in reports of our subcommittees are accessible on our website, www.lumen.luc.edu/internal/profcomm/, and a longer statement on professionalism is attached. We hope these materials will foster a further campus-wide dialogue on these matters. In the coming months, we will participate in sponsoring a discussion group related to issues of justice and professionalism in health care, student meetings, and work with a variety of committees to implement reforms related to our recommendations. We will post a calendar of these events on the website. You are also welcome to speak to each of us about suggestions you have regarding this topic.

Sincerely,

Mark Kuczewski, PhD
Director, Neiswanger Institute
for Bioethics and Health Policy
Associate Professor, Department of Medicine

Eva Bading, MD
Acting Chair, Family Medicine
Course Director: Developmental Human Biology II

Pamela Derstine, PhD
Director of Curriculum & Faculty Development
Assistant Professor, Division of Cellular & Molecular Biology
Co-course Director: Cell & Molecular Biology

Elisa Gordon, PhD
Assistant Professor, Department of Medicine

Mary Langbein
Assistant Dean for Educational Affairs

Gregory Matz, MD
Professor/Chairman
Department of Otolaryngology

Ash Mansour, MD
Assistant Professor of Surgery

Greg Ozark, MD
Assistant Professor of Internal Medicine/Pediatrics
Program Director: Combined Medicine-Pediatrics Residency program

Charles Webber, PhD
Professor of Physiology
Course Director: Function of Human Body

Teresa Wronski
Associate Dean Student Affairs

Fred Wezeman, PhD
Professor & Director, Musculoskeletal Biology Research Laboratory
Orthopedic Surgery & Rehabilitation
Course Director: Developmental Human Biology I

MEDICAL STUDENT MEMBERS
Mike Takacs - 4th yr.
Sam Johnston - 3rd yr
Ryan De Lee - 2nd yr.
Andrew Makowski - 2nd yr.
Cynthia Brincat, PhD - 1st yr.

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