Over the past year we have undertaken an in-depth discussion of medical professionalism through the lens of Dr. Herbert Swick's 2000 article "Toward a Normative Definition of Medical Professionalism." We have also discussed how we can apply Swick's concepts to EMS practice. I believe the professional behaviors included in the following list, based upon Swick's article, should be a part of every EMS practitioner's education, consideration and practice. An EMS practitioner will:
- Subordinate their personal interests to the interests of others.
- Adhere to high moral and ethical standards.
- Respond to society's needs and recognize a social contract with the communities they serve.
- Demonstrate core humanistic values: honesty, integrity, caring, compassion, altruism, empathy, respect for others and trustworthiness.
- Exercise accountability for oneself and one's colleagues.
- Demonstrate a continuing commitment to personal excellence.
- Exhibit a commitment to scholarship and advancing our field.
- Deal with high levels of complexity and uncertainty.
- Reflect upon their actions and decisions.1
These behaviors should be in the forefront of our minds in the classroom and in the field. They should be guiding principles for our ongoing growth and development. When we look forward at how we can improve, these principles can give us structure. When we look back to assess and analyze our practice, these behaviors provide criteria to which we can compare our personal performance.
Let's briefly review each of these behaviors from the perspective of our practice.
Subordinate personal interests--Putting others' needs ahead of our own is sometimes hard to do, particularly when we feel like our own needs are not being met. It is hard to be nice when you're tired or hungry or feel unappreciated, abandoned or oppressed. Overcoming these feelings requires us to look back on why we chose this line of work in the first place, and why we choose to stay in it. I like to think people in EMS still do this work because they want to help people. It may be hard, but your patients will feel better when you put their needs first. Oddly enough, you'll feel better too.
It's not logical, but emotions rarely are. When we are dealing with feeling and emotion, what seems to be "taking care of Number One" often turns out to do more harm than good. The statement "It is better to give than to receive" comes to mind. Think about it.
Adhere to high moral and ethical standards--To follow this rule, we first must understand what the terms moral and ethical mean. Moral concerns principles of what is right and wrong and how we behave related to those principles. Ethical concerns behavior conforming to accepted professional standards. These ideas are closely related and subtly different.
If we wish to judge ourselves, our practice and EMS as a profession, we must first have a clear set of standards. Consider the standards of acceptable and desirable behavior. These standards are most often articulated in a code of conduct or ethics. See Part 3 of this series for a version of an EMS code of ethics.
Respond to society's needs--As EMS practitioners, we have an obligation to serve the needs of our communities. We have a specific duty to act that is often part of the enabling EMS legislation that authorizes us to practice. The first part of responding to society's needs is to assess just what those needs are. Once we identify the specific needs of our communities, we can take steps to meet them.
There is also a second part of this behavior: acknowledging our contract with those we serve. The most important part of our contract is the agreement to respond. When someone calls for help, it is our responsibility and obligation to answer.