Medical Ethics- What has Happened to Medical Professionalism?

One of the reasons that compelled me to leave the operating room environment and extract myself from medicine completely was my continuous exposure to situations of intense conflict with different hospital staff that would leave me feeling abused and mal-treated with my rights almost always having been stripped away from me.

Since I left I have made it a point to write about the injustice and professionalism I witnessed in the medical system here in Halifax. During my research I came across this study which was published in Journal of Clinical Anesthesia (2007) 19, 152158, an issue I advise every medical professional to have a copy of and read through it at least once as these are things we are not taught in medical school or during residency training.

In this article Jonathan D. Katz MD, explains that there are several characteristics of the health care environment that make it especially susceptible to frequent and potentially intense conflict as working closely are a number of highly educated and experienced professionals, optimally all sharing one goalpatient carebut each having a distinct role and responsibility.

People in these work places frequently hold different personal value systems with widely divergent opinions regarding the type of care to be provided and ultimate patient disposition and in this context, it is not surprising that conflict occurs during the management of 50% to 78% of patients.

He also explains that the potential for interpersonal conflict is especially heightened in the operating room (OR), where a broad range of professionals (physicians, nurses, technicians) have overlapping and, in many cases, poorly delineated areas of responsibility. For example, the OR is the only location within a hospital where two coequal physicians regularly and simultaneously share responsibility for one patient. Decisions involving life and death are routine, and wrong decisions resulting in adverse outcomes are subjected to intense scrutiny and retrospective analysis. Sleep deprivation and production pressure add to what is already a stressful and volatile work environment.

He explains the Sources Of Conflict:

Conflict can occur between physicians and patients, physicians and families, physicians and nurses, and physicians and physicians. Conflict occurs on a continuum, ranging from minor disagreements and differences of opinion, to personality clashes, to blatant hostility

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