© Springer International Publishing AG 2018 265
T.S. Köhler, B. Schwartz (eds.), Surgeons as Educators,
https://doi.org/10.1007/978-3-319-64728-9_16
Promoting Professionalism
Hilary Sanfey
Introduction
Unprofessional behavior can be defined in different ways. Such behavior represents
a deficiency in one of the Accreditation Council for Graduate Medical Education
(ACGME) competencies [ 1 ], i.e., the individual fails to meet the standard of perfor-
mance in one or more of the ACGME competencies [ 2 ]. Since unprofessional behav-
ior can have a wide impact on colleagues and patients, such behavior meets the
American Medical Association (AMA) definition of “disruptive behavior,” i.e., per-
sonal conduct whether verbal or physical that negatively affects or that potentially
may negatively affect patient care. This includes but is not limited to conduct that
interferes with one’s ability to work with other members of the healthcare team [ 3 ].
In 2008, the Joint Commission further defined such behavior as “behavior that
undermines a culture of safety” [ 4 ]. This is appealing because it reminds us that our
most important consideration should be the safety of our patients and that institu-
tional leaders are required to have policies in place that address such behaviors
regardless of the underlying cause. On the other hand, any reasonable conduct to
advocate for patients and recommend improvements in patient care is appropriate
[ 5 ]. Physicians who criticize the healthcare system in good faith with the aim of
improving patient care should not be silenced or reprimanded. Individual whistle-
blowers with good ideas, even when well presented, may be falsely labeled disrup-
tive as a tactic to silence them. A good message can be destroyed by a bad delivery,
and the focus becomes the objectionable delivery rather than the issues that caused
the physician to express anger [ 6 ].
H. Sanfey, MB, BCh, MHPE, FACS
SIU School of Medicine, Department of Surgery,
PO Box 19638, Springfield, IL 62794, USA
e-mail: [email protected]