Modern medical professionalism

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126 Pages Softback

Maintaining patients" trust: the need for a change in medical professionalism


The era of accessible information is changing the way people shop, book transport and arrange holidays. Better mobile devices are causing a revolution in the way people communicate, and the phenomenon of social networking is leading to profound changes in society. These issues, set against the backdrop of continuing failure of the NHS to assure satisfactory standards of care for patients (such as the events at Mid Staffs Hospital NHS Trust), are leading to patients demanding more accountability from the medical profession and the hospitals where they are treated.

The Society for Cardiothoracic Surgery in Great Britain & Ireland has been responding to the need for better governance and patient information by its endeavours to collect, analyse and publish mortality rates for cardiac surgery. These data are now publicly available for all hospitals in the United Kingdom, and about 85% of individual surgeons. The initiative has been associated with marked improvements in quality, such that the United Kingdom overall mortality rate for coronary artery surgery is better than the European standard. Cardiac surgeons remain the only group to publish results proactively at the level of individual consultants.

The developments in cardiac surgery have happened gradually and, as we have moved toward a more open culture with respect to our results, we have come to understand the need to put the patients and their quality of care truly at the heart of our service delivery. We have learnt the need to introduce tough but sensitive and humane processes to identify and eliminate care that is not as good as it should be, as well as supporting overall quality improvement. We have also come to realise that wider aspects of medical professionalism need to change to ensure the best quality of care for patients and maintain their trust.

We have summarised our story alongside some outside observations in this book and include thoughts on:

  • The collection, analysis and publication of clinical outcomes data for patients
  • The need for effective continuing professional education for doctors to ensure and demonstrate that they are up to date.
  • The role of measurement of patient experience, multi-source feedback for professionals and appropriate organisational culture to support optimal medical professionalism.
  • The costs of delivering this model, which suggest that the resource required to measure the outcomes is more that matched by the savings derived from better quality of care.

We hope that this report will be of interest to patients, the wider public, policy makers, and to our colleagues across medicine who are working towards a similar objective in their own fields.