Professionalism in Psychiatry

Physicians and psychiatrists typically see themselves as true professionals. But in the past, some displayed behavior far beneath the confines of professionalism, including exploding at nurses, not returning calls, or conducting insensitive interactions with patients, that was usually tolerated and seldom disciplined. Today, the rise of professionalism in medicine in general and psychiatry in particular has prompted a quiet revolution in how doctors are trained and how they are expected to behave in the workplace. The Accreditation Council for Graduate Medical Education (ACGME) has now advanced professionalism to be one of the core competencies all emerging practitioners must have.

While almost all physicians believe in professionalism, the movement toward making it a core competency has challenged doctors everywhere to accept the practice of monitoring, observing and assessing what is not always welcome in a field where autonomy is so highly valued. In Professionalism in Psychiatry, the authors identify and expand on professional behaviors, such as being a good team player, being accountable, pursuing improvement in an ongoing way, and behaving compassionately toward patients and families. The importance of treating all co-workers with respect and of being attuned to the management of healthcare resources in a way that reflects fairness and integrity is also thoroughly reviewed. Important features of this book are:

• Tailoring professionalism principles from medicine to the unique features of psychiatry in order to enhance educators' teaching and improve the behaviors of psychiatrists and residents in the work setting.
• Development of guidelines for professionalism in cyberspace to provide psychiatrists with an ethical framework for dealing with patients in the online realm.
• Discussion of the ethical principles that apply when academic departments approach donors.
• Focus on cultural competency and empathy in an effort to improve patient care through greater understanding and sensitivity to ethnic, racial, gender and sexual orientation issues encountered in clinical practice.
• Use of numerous clinical examples to articulate the new professionalism in psychiatry, which illustrates the importance of going beyond "one size fits all" thinking.

Professionalism in Psychiatry is an important contribution toward beginning to characterize the ever-evolving professional behaviors and clinical strategies of the contemporary psychiatrist and place them in a systematic framework.

“"Written by some of the leading authors in North American psychiatry, this book begins the thoughtful discussion about how to address and teach deficiencies in professionalism. As they suggest, lapses in professionalism among medical practitioners has often been overlooked or explained away by enablers. This book was not designed to end the conversation, but to encourage discussion of issues related to professionalism using the context of clinical situations in psychiatry. In many cases, the vignettes raise as many questions as they answer, forcing readers to examine their own moral foundations. In particular, the chapter on cyberspace is timely and illustrates the widening gap in the use of technology between those guiding residents in training and those being trained, with the latter often significantly more knowledgeable and sophisticated in its use. It is an excellent start to an ever-evolving dialogue."- Steven T. Herron, M.D., Doody Enterprises, Inc. , Februrary 2012”

Written by some of the leading authors in North American psychiatry, this book begins the thoughtful discussion about how to address and teach deficiencies in professionalism. As they suggest, lapses in professionalism among medical practitioners has often been overlooked or explained away by enablers. This book was not designed to end the conversation, but to encourage discussion of issues related to professionalism using the context of clinical situations in psychiatry. In many cases, the vignettes raise as many questions as they answer, forcing readers to examine their own moral foundations. In particular, the chapter on cyberspace is timely and illustrates the widening gap in the use of technology between those guiding residents in training and those being trained, with the latter often significantly more knowledgeable and sophisticated in its use. It is an excellent start to an ever-evolving dialogue.

This is the best "one-stop shopping" book published on professionalism in our field. It addresses nearly every substantive issue faced by the psychiatrist and resident. It is well written and integrates important points through the use of clinical vignettes. This book should be required reading in every psychiatry residency program in the country and, for that matter, in other countries as well. Psychiatric hospital administrators, academic psychiatrists (remember the hidden curriculum), and nonacademic psychiatrists will also benefit from reading this book. Professionalism in Psychiatry addresses the fundamental ethical and professional topics required for program accreditation. Most importantly, however, attention to the issues in the book will enhance everyone's practice of psychiatry.

This book covers a range of issues relevant to professionalism in psychiatry in both breadth as well as depth. If one is teaching residents about professionalism, or even considering how or whether to do so, this is the book to use.

Glen O. Gabbard, M.D., is Professor of Psychiatry at SUNY Upstate Medical University in Syracuse, New York; Clinical Professor of Psychiatry at Baylor College of Medicine in Houston, Texas; and Training and Supervising Analyst at the Center for Psychoanalytic Studies in Houston, Texas.

Laura Weiss Roberts, M.D., M.A., is Chairman and Katharine Dexter McCormick and Stanley McCormick Memorial Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine in Stanford, California.

Holly Crisp-Han, M.D., is Clinical Assistant Professor of Psychiatry at Baylor College of Medicine in Houston, Texas; and Candidate at the Center for Psychoanalytic Studies in Houston, Texas.

Valdesha Ball, M.D., is Clinical Assistant Professor of Psychiatry at Baylor College of Medicine in Houston, Texas.

Gabrielle Hobday, M.D., is Clinical Assistant Professor of Psychiatry at Baylor College of Medicine in Houston, Texas.

Funmilayo Rachal, M.D., is Forensic Psychiatry Fellow in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine in Atlanta, Georgia.

Physicians and psychiatrists typically see themselves as true professionals. But in the past, some displayed behavior far beneath the confines of professionalism, including exploding at nurses, not returning calls, or conducting insensitive interactions with patients, that was usually tolerated and seldom disciplined. Today, the rise of professionalism in medicine in general and psychiatry in particular has prompted a quiet revolution in how doctors are trained and how they are expected to behave in the workplace. The Accreditation Council for Graduate Medical Education (ACGME) has now advanced professionalism to be one of the core competencies all emerging practitioners must have. While almost all physicians believe in professionalism, the movement toward making it a core competency has challenged doctors everywhere to accept the practice of monitoring, observing and assessing what is not always welcome in a field where autonomy is so highly valued. In Professionalism in Psychiatry, the authors identify and expand on professional behaviors, such as being a good team player, being accountable, pursuing improvement in an ongoing way, and behaving compassionately toward patients and families. The importance of treating all co-workers with respect and of being attuned to the management of healthcare resources in a way that reflects fairness and integrity is also thoroughly reviewed. Important features of this book are: Tailoring professionalism principles from medicine to the unique features of psychiatry in order to enhance educators' teaching and improve the behaviors of psychiatrists and residents in the work setting. Development of guidelines for professionalism in cyberspace to provide psychiatrists with an ethical framework for dealing with patients in the online realm. Discussion of the ethical principles that apply when academic departments approach donors. Focus on cultural competency and empathy in an effort to improve patient care through greater understanding and sensitivity to ethnic, racial, gender and sexual orientation issues encountered in clinical practice. Use of numerous clinical examples to articulate the new professionalism in psychiatry, which illustrates the importance of going beyond "one size fits all" thinking. Professionalism in Psychiatry is an important contribution toward beginning to characterize the ever-evolving professional behaviors and clinical strategies of the contemporary psychiatrist and place them in a systematic framework.

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