Defining Professionalism from a Patient, Physician and Nurses Perspective

Please review the results from these focus groups and reflect how they relate to pharmacy practice: Importance to the pharmacy profession Settings/situations where it relates to the profession of pharmacy Table 1: Signs of Professionalism Deemed Very Important by at least 75% of respondents in that category Item Practices in an ethical manner Is honest Discusses confidential information with only appropriate parties Has good hygiene Refers patients to appropriate specialists when needed Pays attention to cleanliness and comfort of patient areas Listens carefully Answers questions from patients and families Works in patients best interest without regard for personal gain Maintains appropriate behavior with patients and families Seeks help when needed Pays attention to detail Takes a genuine interest in the patients health Always gives best effort, regardless if circumstances Shows respect for patients and families Patients N=415 93.7% 93.3% 92% 91.8% 90.9% 90.7% 90.3% 90.1% 89.8% 88.7% 88.6% 88.6% 88.2% 87.3% 87% Nurses N=237 94.5% 97% 92.7% 94.1% 89.7% * 90.7% 94.1% 91.7% 91.9% 85.8% 82.3% 85% 83.2% 94.5% Physicians N=214 99.5% 99.1% 84.4% 79.3% 79.2% * 79% 86.9% 90.1% 95.3% 89.7% 75.7% 81.9% 88.2% Why become a physician if you dont care? Are these physicians in it for the money? Im glad nurses thinks this is important This is drastically different from what patients see important Physicians should learn to listen closely Physicians should answer questions Reflection

Worries me; who are the inappropriate parties that physicians speak to? Is this because nurses are in contact with patients more?

even though the patients dont see it as that important Communicates clearly and effectively Takes direct responsibility for own actions and decisions Keeps patients informed and up to date Follows up to ensure proper care Discusses confidential information in appropriate settings Delivers appropriate care regardless of patients personal characteristics Communicates with other health professionals to coordinate care Prepares before seeing a patient Explores patients needs and concerns Shows compassion and care Involves the patient and/or family in the decisionmaking process Is approachable Responds to phone calls, emails in a timely manner Controls own emotions and maintains composure Is personable and polite Shows respect for colleagues Greets patients appropriately Tailors information to the patients and familys needs Communicates orders clearly and effectively 87% 86.6% 85.7% 84.4% 83.9% 83.2% 81.8% 79.4% 79.1% 78.7% 78.5% 78.3% ^ ^ ^ ^ ^ ^ ^ 89.8% 93.5% 87.2% 86.6% 91% 86.8% 92.8% 76.1% 80% 86.9% 85.5% 80.4% 85.7% 86.4% 84.3% 84.6% 76.7% 77.2% 93.1% 80.4% 93% * * 78.6% 85.2% * * * * * * * 81.3% * * * * 79.8% Physicians see everyone differently? I can understand nurses Although patients dont see this as important I think physicians should still take care of concerns Caring is important Physicians need to consider patients If the provider is not approachable, there is no trust from the patients In the pharmacy, we have to respond before 4 rings How is being polite NOT important? Makes me wonder how physicians and nurses greet patients if they dont see this as important Physicians should be more in tune with how patients feel when delivering news This will only cause more problems for the patients if physicians do care enough Im glad nurses follow up Reading the article for this week, Im not surprised that doctors dont see this as important

Only documents work that has been done Maintains appropriate behavior with coworkers Serves as a patient advocate Keeps current with the literature Speaks respectfully about patients Demonstrates a team-player mentality Is willing to admit mistakes Admits when doesnt know something Speaks respectfully about other health care providers Shows sensitivity to different cultures

^ ^ ^ ^ ^ ^ ^ ^ ^ ^

87.6% 86.9% 86.5% 85.1% 85.3% 84.1% 82.7% 82.6% 79.5% 79.7%

84.9% 78.8% * * * * 78.8% 79.4% * *

I see pharmacists doing this more Things change in healthcare Do they make fun of patients? Physicians think they can handle everything? Mistakes are bad, but everyone makes them every now and then Dont just make stuff up Again, is it because physicians are cynical? This makes me uncomfortable, know that physicians and nurses are insensitive

^ Not included in patient survey because not always transparent to patients *Indicates that fewer of 75% found it very important

Table 2: Signs of Professionalism Not Deemed Very Important by 75% of respondents in that category Item Is available to patients and families when needed Takes the patients values and situation into account Keeps commitments or acknowledges waiting time Serves as a positive role model Dresses appropriately Responds to constructive or positive feedback Completes documentation in a positive manner Keeps personal reactions to themselves Avoids nonscientific relationships with the Patients 73.6% 64.5% 59.9% 52.6% 35.5% ^ ^ ^ ^ Nurse 70.1% 71.7% 71.7% 64.3% 53% 72.2% 66.4% 73.4% 48.7% Physician 55.7% 53.8% 39.8% 55.7% 37.1% 58.5% 51.6% 49.8% 40.5% Reflection I think this is important from the viewpoint of pharmacists

Appearance can make an impression about the healthcare provider or the clinic/hospital/etc

pharmaceutical industry Shows awareness of test and treatment costs ^ 57.8% Shows awareness of public health issues relevant to ^ 64.5% practice ^ Not included in patient survey because not always transparent to patients

36.5% 33.8%

Reference: Green M, Zick A, Makoul G. Defining professionalism from the perspective of patients, physicians and nurses. Academic Medicine 2009;84:566-73.