Thursday, August 9, 2012

Medical Professionalism for PAs (and students thinking of PAdom)

Jim Anderson's article on medical professionalism in this month's JAAPA, brings up some important topics for PAs.  He presents a hypothetical scenario of a supervising physician whose personal life has taken a tumble and their professional conduct has been tarnished by alcohol abuse and a personal, romantic relationship with a patient.  The PA working in this practice has a longstanding relationship with this physician and their obligation of action is brought into focus.

I am very interested in how communication between clinicians and impacts patient care.  This article touches on some key points in communication as well as medical ethics.  The juxtaposition of these two topics is fascinating.

The hypothetical scenario that PA Anderson writes about is shaped by the relationship and rapport that the supervising physician and the PA share.  Therefore, their communication style and habits are key to the central quandary presented in the article.


These are the issues at hand that I see:
  • When does "one" equal "one too many"? OR When is a single violation of ethical behavior at work enough to warrant a whistle blowing action?
  • What are our personal and professional obligations to report bad behavior?
  • When does this become a legal matter that requires participation to avoid legal consequences?
  • How does reporting unethical behavior change our professional relationships?  How does one react to these changes?
  • How are we teaching medical professionalism in PA school?

As I approach the start of my PA school, I am eager to learn more about how we handle situations that challenge our interpretation of medical professionalism.  I've just completed a course this summer in Medical Ethics and was exposed to many fascinating case studies and situations.  I wrote a post on my privilege theory that evolved from my theory of "don't do dumb stuff."

I have worked in healthcare for the last twenty years and have seen instances in the workplace that called for intervention or at least reporting to a manager for action. 

Often the guidelines and standards we learn in school are difficult to apply to the gray edges of everyday life.  We make friendships and collegiate alliances with those we work with and seeing exactly how to act and doing so at the right moment is not always as obvious as it appears in a textbook or classroom scenario.

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