About a month ago, I
was invited by one of the Hospital’s departments, where we provide postgraduate
courses and specialty certifications in a highly complex area of Medicine. I
was to accompany a retired Clinical Professor from both the public and private
medical schools, who at present devotes himself to investigate, publish and
teach in the rich areas of Medical Humanism and Medical Professionalism. When
he turned eighty, he published a book, where he both synthesises and expands on
both concepts. The residents are asked to read the book reflectively and to
write either a summary or the impressions they have, of the specific chapters
covered in each of the fortnightly workshops and describe a personal encounter
with a patient, that is relevant to the subject. My natural anxiety made me
read the book from cover to cover in less than a week.
The author
distinguishes between Humanism and Professionalism, their different sources,
history and relevance to modern medical practice. After reading through the
book, I summarised my impressions and did my homework. What follows is what I
wrote and presented at the following meeting.
“In the first place, Professionalism has to do
with a set of rules, that have their source in the person of the physician,
either alone or as a group, from those who require their services and from the
society within which they practise. Therefore, those who choose the medical
profession, have to abide by these rules that regulate how he or she behaves,
individually and with relation to his or her colleagues, with their patients,
with the organisations within which they work and finally, with organised
society as a whole. These rules may be explicit in laws, codes of ethics,
collegial associations and by international entities like the World Medical
Association and the World Health Organisation. They provide the necessary
uniformity between doctors and define the standards of what constitutes being a
physician, how they should be trained and how they should practice. Besides, by
restricting what doctors do to those professionally qualified, physicians are
given a monopoly and exclusive rights over what is considered medical practice.
“In a rather restrictive and reductionist view,
I would describe Professionalism as a vessel, bottle or box, that is similar in
looks and label with other vessels. Society can therefore tell, who qualifies
professionally as a doctor from who doesn’t.
“Humanism, on the other hand, isn’t exclusive
of physicians. Humanism has to do with persons, in a sense: with everybody. It
has to do with one’s values and how they relate to the deepest questions that
life poses to all of us. In other words, Humanism has to do how each of us confronts
our own existence. Humanism has to do with the inevitability of our finitude
and eventual death, with disease and suffering from all causes, with guilt and
what meaning we strive to give to these inevitable dimensions of our own
existence. Humanism, therefore, is what gives life to Professionalism, which I
described earlier as an inert container.
“The vessel of Professionalism should be filled
with the contents of Humanism. Without Humanism, empathy and compassion are
impossible. However, these contents are at risk of deteriorating or emptying
themselves over time, if the physician is not proactive to keep them fresh and
full. Sadly, in the present century, we are to some extent living a crisis of
Humanism, reflected in physician burnout (exhaustion, cynicism and lack of
accomplishment) and worse so, in the worrying incidence of physician suicide.
Therefore, Humanism should be taught, renewed and made central to doctors’
worldview and the vessel of Professionalism kept fresh and full, so as to keep
physicians engaged in work, with meaning, happiness, empathy and compassion.
Isolated Professionalism is empty and potentially selfish, both personally and
corporatively and therefore damaging to a healthy doctor-patient relationship.”
Reference: Correa, H. Humanismo médico. Montevideo:
Fin de Siglo, 2016.
