EDITORIAL

Definition of "Medical Profession", "Medical Professional" and "Medical Professionalism"

Definición de "Profesión médica", "Profesional médico/a" y "Profesionalismo médico"

Juan José Rodríguez Sendín

Presidente del Consejo General de Colegios Oficiales de Médicos (CGCOM).

Sometimes our most cherished piece of jewellery is so carefully hidden away in such a safe place that we even come to forget what it looks like. Some aspects of daily life escape our notice because we fail to stop and examine them face to face or to even think about them. That's the way things are.

The relationship between physician and patient, an integral part of our profession as doctors, is something that continues to occur every day in the most natural way. In fact, it is a relationship that happens in such a natural way that we do not even stop to think about it, about its essence, whether it has varied much, or if the rules of the game are unchanging or whether some new variables have been introduced. Furthermore, I think that many doctors understand the relationship between physician and patient in the same way our grandparents, our parents or even we ourselves understood it some years ago. But those same doctors assure us that society has changed a lot in these last years, that it has become difficult to understand the values of today's society or that the rules of the game are no longer the same -and all this is true. Social and political factors, as well as scientific progress, have set new expectations both for society and for doctors and as a whole this has changed the role of the physician in our society.

The physician-patient relationship now fits, whether we like it or not, within a broader framework that has been called a 'social contract'. Like all contracts, this one (which is by nature tacit) is established between the parties, that is to say, between society and physicians. Consequently, it is to be expected that, if society and its values have changed a lot, then the contract between physician and patient, which is both a corporative and a personal agreement, will also have undergone some modifications. But it must be pointed out that not everything has changed. Some values are still as valid today as they were in the past and it is therefore necessary to highlight both those that have evolved with society and those that remain unchanged. Among these last values, I would underline the trust that is established between doctor and patient owing to its being inherent and necessary for the effectiveness of medical practice and even plays a decisive role in the sustainability of the National Health System. Not even the most meticulous examination or the most thorough battery of diagnostic tests can replace the information obtained from the patient within a framework of mutual trust.

All these reasons have led the General Council of Official Medical Associations in Spain (CGCOM), like many other international medical corporations, to deem it necessary to look at society face to face and reflect on the characteristics of the social contract between physician and patient and how it has changed. After a careful analysis, on March 20th 2010, the Assembly of the Spanish General Medical Council (OMC) approved a set of deliberations that, in the form of definitions, aim to keep us from forgetting who we have a duty to and what we have a commitment to.

In the following, we outline the conceptualisation of three terms that are closely related with our profession: 'medical profession', 'medical professional' and 'medical professionalism'. These definitions are just the beginning of a path, not its end. We take on the responsibility of regularly updating what must be the professional ideology of the OMC and must keep pace with society.

By approving these definitions, the CGCOM wishes to convey a simple, but very significant, idea. Quite simply we want to make it known that in order to provide high quality health care, each physician who practises in Spain must not only possess the greatest possible amount of the knowledge and skills needed for the job, but must also commit him or herself to a set of values, display a series of attitudes and behave in a way that, as a whole, is known to the international scientific community as 'medical professionalism'.

I do not want to end without underlining something that may seem obvious. This standpoint that the CGCOM today makes publicly known is not aimed only at doctors, who have mostly exercised medical professionalism since they began their careers. We are addressing the students who will be tomorrow's doctors, we are addressing all the health care professions, and we are addressing the academics and the Authorities. But, above all, what we want to do is to state our commitment with the individual patient and with society as a whole. Both patient and society value the physician positively and place their trust in the medical profession; we, the profession and the physicians, are honoured by such confidence and in return offer our commitment to show and prove that what guides us is the quality of our medical practice.

Medical Profession

The Medical Profession is an occupation that performs tasks addressed to promote and restore health and to identify, diagnose and cure diseases, utilizing a superior body of specialized knowledge presided by a spirit of service so that the benefits of the professionals are the consequence of the benefits obtained by the patients, for which purpose there is a requirement to warrant: the production, transmission and utilization of scientific knowledge; the constant improvement of the best possible care; the ethical and competent use of knowledge; and the orientation of the professional practice to the health needs and wellbeing of the people and the communities.

Medical Professional

The Medical Professional is a university medical school graduate committed to the ethical principles and values of the medical profession -medical professionalism- which behavior follows them strictly.

Medical Professionalism

Medical Professionalism is the professed believes consisting in a set of ethical and deontological principles and values supporting the professional commitment of service to the citizens that evolve with the societal changes and support the trust of the people on the physicians.

• Fundamental principles of the medical professionalism

The professional practice demands that the patients interests are never surrogated to the medical interests, based on the trust of the patient on the physician and on the other ethical principles of beneficence, no maleficence, autonomy and justice.

• Fundamental values of the medical professionalism

The medical profession provides them with knowledge, skills and judgment to promote health, prevent and protect from diseases, and maintain and improve the wellbeing of the citizens. The daily practice of the medical professional implies a commitment to:

• Integrity in the use of knowledge and resources.

• Compassion as a guiding principle when dealing with suffering.

• Continuous improvement of the professional performance in order to warrant the best possible care.

• Cooperation with all health professionals and health care providing institutions in order to improve the people's health and wellbeing.