Professionalism means dedication, competence, compassion and moral accountability, all traits that have characterized the best doctors in every era since Hippocrates, the president of the American Medical Association said Thursday.
Dr. John J. Ring, a family physician from Mundelein, Ill., told the Utah Medical Association's House of Delegates, which gathered for its 97th annual meeting at University Park Hotel, that he has chosen professionalism as the theme for his presidency.The delegates are the ultimate policy-making body for the some 2,800 members of the association.
Professionalism, Ring said, is "to us doctors our very identity as doctors. And the basic act of professionalism is a doctor taking care" of and maintaining a proper relationship with his patient.
"We can accept nothing that threatens this relationship," he said, such as "turning medicine into a mere trade, a dispassionate business venture, an impersonal public utility or being maneuvered into working for anyone - other than our patients."
In an interview, Ring defined a "truly compassionate physician as somebody who shares a burden of illness, providing the best advice and care you can, lifting that burden of illness when you can and making it lighter when that is all you can do."
In the meeting with delegates, the physician discussed professionalism in the context of HIV testing, physician payment reform and access to care.
He quoted Belinda Mason, an eastern Kentucky woman who recently died of AIDS and who two years ago was appointed by President Bush to the National Commission on AIDS.
In a letter to Bush, Mason, who became infected from a transfusion she received during the birth of her second child, said that the "blanket screening of health-care professionals will create a false illusion that people with AIDS are a threat to others. Doctors don't give people AIDS - they take care of people with AIDS," she said.
Ring said the only known case of AIDS transmission from a health-care worker to a patient is the case of a Florida dentist who transmitted the disease to several patients, "and no one can quite figure out how he did it."
The AMA president said the medical profession has been on the compassionate forefront in dealing with the disease. Earlier this year, the AMA Board of Trustees went on record as urging infected doctors not to perform procedures that pose an identifiable risk to patients without first obtaining the full, informed consent of the patient.
Ring said the HIV-testing question will probably continue to attract "lots of public attention, some public hysteria and much public misunderstanding. But we must continue to deal with it in the context of the doctor-patient relationship."
In his address and in a press conference, Ring discussed problems surrounding the mounting numbers of uninsured and underinsured people, noting that 31 million citizens are without health insurance.
He said the medical profession is responsible for their medical care and thanked Utah physicians for their support of "Health Access America," a 16-point program designed to cover such individuals, to reduce costs and to ensure quality care.
Ring reviewed the federally and state-funded Medicaid program, designed for the poorest of the poor. He said the AMA encourages doctors to accept Medicaid patients but that physicians must at least be reimbursed for their expenses. Many physicians, he said, contend that they can't care for such patients because it costs them more money than they receive.
He said the AMA proposes covering the 31 million uninsured people. "These people are not dying on the streets . . . of ruptured appendices that the doctor won't take care of. But we have solid scientific evidence now that when they do get care the outcomes of that care are not as good as the outcomes of care for the insured population."
Ring said the uninsured are the "tip of the iceberg. The real issue is us. Are we a profession to which business interest is incidental or are we a business to which our professionalism is incidental? Are we entrepreneurs or are we servants of the sick?"