The Weaponization of Medical Professionalism

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Excerpt

I once proposed to a physician that his clinic should add an “Other” option for gender on its demographics forms, given the large surrounding lesbian/gay/bisexual/transgender/queer/intersex/asexual population. The physician immediately discounted this idea, deeming it “unnecessary” and “tedious.” When I explained how these alterations could increase the quality of the health care he provided, he deemed me “unprofessional” and asked me to leave his office.
Medical professionalism is espoused as a necessity in health care, setting an important precedent of excellence and respect towards peers and patients. In many medical schools, a portion of the curriculum is dedicated to the intricacies of medical professionalism. Though typically taught through specific tenets and case studies, professionalism is still a general principle, resulting in varied definitions across institutions. This is, in fact, part of the beauty of professionalism—the lack of definition makes it a flexible concept, applicable in a wide variety of situations.
However, the downside to this vagary is that it allows for the weaponization of professionalism, leaving space for “professionals” to reject certain approaches to health care. Further, since the concept of medical professionalism itself was devised by and upholds the tradition of the most powerful voices in the field—most generally wealthy white men—this weaponization can damage the diversity of appearances (hijabs, African American dreadlocks), mannerisms (slang with patients from a low socioeconomic status), and proposed changes to health care administration of minority groups in medicine. Instead of being used flexibly, professionalism can be twisted to keep medicine rigid and conforming to the standards of the powerful.
This phenomenon has created stagnation in the medical field as new approaches have been rejected to conform with established traditions. This is problematic; to provide the best possible health care, medicine must be forward-thinking. When vague concepts like professionalism linger in our daily vocabulary, setting up harmful systems of bullying, prejudice, and self-entitlement, how can we begin to revamp a system that is so often criticized for burning out its residents, discriminating against minority populations, and administering paternalistic care?
As medical professionals, we have to begin understanding the ramifications of “professionalism” within our field. Simply “being unprofessional” should no longer be a sufficient reason to discount an idea or individual. The field must move forward either to give more standardized definitions of professionalism or to dispose of the concept altogether. In academic medicine, professionalism should be a springboard for critical thought, not a barrier to innovation and change.
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