- Dr. B.J.C. Perera on how to put patients first
Professionalism is the basis of medicine’s contract with society. It demands placing the interests of patients above those of the physician, setting and maintaining standards of competence and integrity, and providing expert advice to society on matters of health.
The Sri Lanka Medical Association’s (SLMA) Young Members’ Forum recently held a webinar that discussed professionalism in the medical field in the Sri Lankan context. The discussion featured specialist, consultant paediatrician, Sri Lanka College of Paediatricians (SLCP) Founder President, and SLMA Past President Dr. B.J.C. Perera who elaborated on the topic.
Beginning the webinar, the moderator of the forum, Dr. Ashwini de Abrew, explained that the main objective of the SLMA Young Members’ Forum is to educate young doctors in soft skills, including professionalism, managing ethical dilemmas, self-care, work-life balance, and other life skills that are needed in their profession.
Dr. Perera began by diving into the definition of professionalism. “It is basically the competence or skills expected of a professional. It is commonly understood as an individual’s adherence to a set of standards, code of conduct, and a collection of qualities that characterise the accepted practice in a particular area of activity.” Although this may be true for most fields, professionalism in medicine is multifactorial and a variety of skills are needed, and according to Dr. Perera “it is basically the way one interacts with fellow human beings who have some kind of medical problem”.
He also explained that there are six essential traits of a professional, which he named to be dependability, respectfulness despite the other’s background or class, ethicalism, positivity, and one’s ability to be a team player. He also stated that when it comes to a doctor’s most important attributes, they must be able to have the patient at the centre of their attention, rather than themselves and they must also be able to care for humans and maintain integrity. “Good doctors make the care of their patients their first concern; they are competent, keep their knowledge and skills up to date, establish and maintain good relationships with patients and colleagues, are honest and trustworthy, and act with integrity and within the law. They treat each patient as an individual,” Dr. Perera added.
When people refer to medical professionals, most would immediately restrict the term to doctors, but Dr. Perera highlighted that there are many other key players like nurses, dietitians, medical technologists, social workers, pharmacists, and many others.
The key to professionalism
According to Dr. Perera, the key to professionalism by doctors includes punctuality, responsibility, wearing the appropriate attire, honesty, and being diligent and conscientious at all times.
He also highlighted the importance of sticking to Her Majesty’s English (British English) as even though that is a second language, it is the language the medicine is in and it is the language they studied in. “In this sense, doctors should avoid using terms like ‘aiya’, ‘nangi’, etc. and stick to conversing in professional English. Sharing an anecdote on the topic, he said: “In 1961, I was in my Ordinary Level (O/L) class and suddenly, I had to switch over completely from Sinhala medium to English. Back then, my command of the English language was absolutely atrocious. We did have an English class when I was in Sinhala medium, but the students were mostly Burghers and Tamils so they were already proficient in the language, so I didn’t speak to any of them.”
He further explained that during his first-ever English class, the teacher required them to write essays and the next day, upon correction, the teacher gave everyone else their corrected essays except Dr. Perera’s, and kept him after class to question him on what “nonsense” he had written. It was then that his teacher uttered seven golden words which changed his life and made his future: “You won’t get anywhere without learning English.” This was when he realised that English is incredibly important, especially in the field of medicine, as the patient needs to be properly communicated with.
He also highlighted that another important part of professionalism is overcoming personal discomfort. “Even if you haven’t slept properly, you must not show it to your patient. It is important that they feel their needs are being met and that you are paying attention to them in order for them to be comfortable and gain their trust.”
Doctors also must commit to a lifelong quest of knowledge, according to Dr. Perera. “The medical field changes every day. There are new breakthroughs and findings and it is important that as doctors, we stay on top of it and constantly keep learning.”
When concluding the webinar, Dr. Perera explained that all humans have weaknesses, and that even doctors make mistakes. In that sense, he commented that empathy is an essential emotion to have, especially in times when they are in the wrong.
“In these times, we must own up to our mistakes and take responsibility for our actions. That is a mark of true professionalism.”
