Thoughts on professionalism outside of the workplace

[dantay]

The point isn’t to discuss my neuroticism (although a few of the illustrative points may involve that). But, I’m interested in your thoughts about professional conduct and how much it extends into your private life.

I take professionalism seriously, especially in front of patients, professors, attendings, and deans. Rarely in front of my boss, coworkers and fellow students while at work/school, I may let my hair down a little (meaning, I would relax a little but would still be within the range of normal professional conduct). But to what extent do you personally feel that it extends into your private life?

I started thinking about this with SDN. I do not post things that I wouldn’t say in person, but there is obviously a different context in the professional forums (semi-serious) and the lounge forums (beyond casual). But, I might feel a little weird if my school’s dean of admissions, a residency program director, or my mentor ventured into the lounge – if they didn’t know my sense of humor, they'd probably think I have substantial psychological comorbidity.

Taking this internet/print side of things a step further – our school recently had a discussion about the educational environment (illustrative example and what I think should be fine information in the public domain). The controversy started with a letter to the editor of the local paper criticizing the med school (not from a med student but from someone close to one). In response, at least one other student responded via blog (as well as others writing letters/articles publicly). Anyway – I’m not suggesting that providing criticism to the medical profession, specific institutions (whether hospital or medical school), or perhaps even specific providers is inappropriate. But, how do you feel about conduct (in this case, publicly written information either published or electronically in an unedited form) that airs “medicine’s dirty laundry”? For clarity – I’m not saying that critical books, cartoons, essays, or blogs are bad. But, when might it be unprofessional to do so? When it’s derogatory to an individual or group of individuals? Would it be unprofessional to bash surgeons in general? How about the surgery dept at my institution? Or a specific attending? What if I said, “All medical students are arrogant pricks.”? Or, limited this to gunners? Or, those 2 handraisers in the front row? Aside from personal attacks, is it unprofessional to make strange public statements (say, based on no scientific fact – like if I was an MD hocking the equivalent of the “Astrology Cures they don’t want you to know about”)?

Changing examples: med school parties. Sure – I imagine all schools have social functions (and med students can throw houseparties like anyone else). Random stuff happens at parties – hooking up, being an ass, puking on the futon, general merriment. But, it’s an isolated environment. Take the same party and put it in a random bar. Does it matter if it’s 30 med students on a bar crawl or who randomly decide to go to Bar X? What if it was initially reserved under the name of a medical student association?

There was a post last year on SDN – some M1 seemed really upset about being asked to go a strip club with friends, for fear of being seen there. Is the situation different if it’s four or less people? I mean, it’s just a random group of friends going out. But does the context change if you were wearing an “Ivy League State College of Medicine” sweatshirt? What if it was after a med school party and 15-20 people decided to go as a group? This happened to a friend of mine, actually – she went with a bunch of guys to a strip club (the whole group was med students, and the guys regularly went). But, when SHE got a lapdance for fun, one of the guys flipped out on her, saying how unprofessional it was.

Alcohol is obviously a touchy situation – most appreciate that a DUI for a med student is a different beast than a DUI for, say, an engineering professional student. So, what if you were just a bastard driver but had an MD license plate (or ILSCOM window sticker)? Does that reflect poorly on the profession?

What if you are publicly involved in controversial organizations? What if you had a bunch of witchcraft stickers? Or white power and swastikas stenciled on your car? A friend of mine was arrested at a peace protest - is that unprofessional? What if she was wear her white coat at the time as part of the demonstration?

Being part of a profession probably cannot dictate beliefs, but it can dictate behavior. If you delve into the history of professionalism, you understand the differences between a profession and a job. I’ve obviously seen a lot of posts in SDN that say that medicine is just a job, but I also feel a substantial proportion of students do not feel this way.

Discuss

[Blue Dog]

Originally Posted by dante201

I’m interested in your thoughts about professional conduct and how much it extends into your private life.

It matters. Certain infractions, like DUI, can and usually will affect your professional status, as most (if not all) states will report DUIs and other substance abuse-related offenses to the state medical board. Ditto felony convictions, sex offenses, and so on. These can affect your license, credentialing, etc.

Other issues, such as bad behavior, bizarre beliefs, or unusual interests and activities outside of work, also have the potential to reflect negatively on you professionally. If other doctors think you're a jerk or a whack job, they're not likely to refer patients to you. Patients may feel similarly.

It's best to keep everything above board.

[YouDontKnowJack]

ok. i lost my concentration 1/4 way through that post. After that one Apprentice episode, I now strongly believe in the saying, "keep it simple, stupid".

anyhow, based on the thread title, outside of the workplace, i spit, burp, fart, cuss, and usually in public too. But there are other rednecks that are worse.
However, I will open a door for a lady.

[mysophobe]

I lost concentration after looking at that dog.

[crys20]

dante is that a japanese chin puppy??

[t33sg1rl]

This is a really good question... I know of a case very peripherally where a first year student was suspended with possibility of explusion because of his blog, which apparently contained criticisms of medicine and his school. Apparently he also made comments about how he hated patients and was in medicine for the money.
Now, I don't know any of the actual facts, only what came down the rumor mill, but I am certain of two things: one, that the student was in serious trouble, and two, that it was because of something he wrote in an online blog.
While I don't want to be treated by a doctor who's only doing it for money and couldn't care less about me, the fact remains that the school in this case acted like 1984 thought police. Clearly, they felt that his blog constituted unprofessional behavior, even though it was on his own time, in his own space, and was nothing more than his opinion.
What do you think of this case? Did the school go too far, or is suspension appropriate?

[nala]

I certainly don't mean to take this threaad off topic, but there have been people fired from their jobs for complaining about their employer in an online blog. Employers feel it is bad publicity for them. This has happened with more than one employer in more than one field. So I'm not totally surprised that the school was annoyed, depending on what was said in the blog. I'm not saying I think it is ok, I'm just saying it has happened outside of the education system as well.

[akpete]

Actually, there was recently an article in the St Paul, MN paper about this stuff. Apparently it is becoming more and more common for schools and even police to browse through myspace, facebook, blogs, etc. looking for various things. The article made no opinion at the end, but where do your free speech rights come into play?

I think it's one thing to act like an idiot or whatever when people don't know who you are. But it's certainly another when you're at school-sponsored functions and you need to be sent to detox. Not that it happened here...


By the way, that was not me!!

[lil pook]

anyone dumb enough to talk smack about his job/work/school etc. probably deserves whatever happens. i mean, saying it verbally is one thing...hard to prove that he said/she said crap. on the other hand WRITING it for all to see is suicide.


but I'm just paranoid that way. i am always careful about what i do or say at school around so called 'friends'. you never know what can happen if you let loose or trust too much......

sad

[MattD]

Originally Posted by dante201

Alcohol is obviously a touchy situation – most appreciate that a DUI for a med student is a different beast than a DUI for, say, an engineering professional student.

Explain? In what way is driving under the influence even moderately more or less acceptable based on what group you're a member of? It's dangerous and immoral regardless of whether you're the guy who cured cancer or the guy who picks up that guy's trash. Also, as an engineer myself, I sorta resent the implication that we are somehow professionals of a lower quality, or lower standards. I don't want a drunk designing the bridge I'm driving over any more than I want a drunk cutting out my brain tumor. Professionals in general should be held to a professional standard regardless of their particular career, but there's no reason to think being a physician somehow magically makes you special or of a higher status than others.

[Samoa]

On the one hand, I can understand the need to present a respectable image at all times. On some level, people will always judge your behavior in terms of whether it's "appropriate for a doctor," even if you are not actually at work.

On the other hand, behaving as though you are always on stage and always having to project a perfect image is a horrible way to live. But the more truth the public knows about you and your life, the more likely it is they'll consider you a bit odd. Everyone has their quirks when you get to know them. And as they say, the only normal people are the ones you don't know very well. So you can be your quirky self on your own time and enjoy your life, or try to manage your image 24/7 and be perpetually tense and anxious.

And you can't live your life afraid to speak your mind, even if what you have to say is unpopular and unwelcome. Yes, it's more effective if it sounds rational and measured, but sometimes it's important just to say something. If an institution retaliates in response to the opinion of some low-level person with no other voice in the organization's decisions, it speaks volumes about that institution. I'd bet that's the least of their problems, and retaliating against someone like that for "unprofessional behavior" is a dysfunctional waste of time.

Now DWI/DUI, or actually breaking the law, would be a different story entirely.

[logic meme]

Life is too damn short to worry about what people are gonna think about what you say or your sense of humor. The benefits that come with being in a democratic capitalism are those freedoms to live your life as you please as long as you aren't harming others. I don't say anything on here I wouldn't also say in real life, but of course I say some crazy $hit in real life too. I think that the entire idea of professionalism is debatable because it is hard to pin down what a professional is. I agree you ought not act idiotic, drinking and what not, but that is because I generally think people ought not act stupid in public or private life. Everyone should just exercise a modicum of control over their behavior in all situations and then we wouldn't need such ridiculous distinctions.

[mlw03]

Originally Posted by dante201

What if you are publicly involved in controversial organizations? What if you had a bunch of witchcraft stickers? Or white power and swastikas stenciled on your car? A friend of mine was arrested at a peace protest - is that unprofessional? What if she was wear her white coat at the time as part of the demonstration?

Discuss

as long as the orginization isn't one with inherently evil goals (ie, KKK or NAMBLA - that southpark was on again last night, what funny stuff), then it's no problem. there are plenty of people that consider pro-choice or pro-life groups controversial, and it's totally fine by me for a doctor to a part of that group and wear their white coat at functions. the interesting part is when you get to iffy groups - say a Palestinian support group with some questionable ties to Islamic jihad - the student would say they're just supporting the Palestinian people, but you could argue they're supporting terrorism. Or a student joining the ELF or ALF (earth/animal liberation front) - same thing with the blurry line between legit cause and terrorism.

at the end of the day though, an individual med student or doctor doing something doesn't represent all of medicine or the field's professionalism. nor does it have to represent the doctor's professionalism. in my opinion, they very well can be separate entities.

[8744]

Originally Posted by dante201

Discuss

No. You're just being a tool.

[dantay]

Originally Posted by crys20

dante is that a japanese chin puppy??

Apparently, according to amsie in the lounge. He's not mine, though.

Originally Posted by mysophobe

I lost concentration after looking at that dog.

He is Fluffy. He's the Destroyer of Worlds. Apparently he also has mind control powers.

[dantay]

Originally Posted by MattD

Explain? In what way is driving under the influence even moderately more or less acceptable based on what group you're a member of? It's dangerous and immoral regardless of whether you're the guy who cured cancer or the guy who picks up that guy's trash. Also, as an engineer myself, I sorta resent the implication that we are somehow professionals of a lower quality, or lower standards. I don't want a drunk designing the bridge I'm driving over any more than I want a drunk cutting out my brain tumor. Professionals in general should be held to a professional standard regardless of their particular career, but there's no reason to think being a physician somehow magically makes you special or of a higher status than others.

I was using engineering as an example. I used it because it’s a profession in the strict sense of the word. (I could be a professional ice sculptor but that doesn’t make ice sculpting a profession.)

Professions are set apart from occupations because they are somewhat self-governing. That is, they decide themselves what the appropriate degree to have is, what is needed for accreditation / licensure, and what the standard code of ethics and conduct is. They have certain rights and priveledges afforded to them but they also have additional responsibilities.

As for the DUI, I’m temporarily ignoring the fact DUI’s are reckless for any driver – but it holds special significance in this conversation. Granted, I’m not an engineer. But I expect that an engineer would have to have continual problems with alcohol for it to threaten their career. But as KentW pointed out, a single DUI can devastate a health professional’s career. It's drilled into our heads on the first day of orientation that people with problems with alcohol should seek treatment immediately because it's not tolerated. I personally know people who have been dismissed from school for a single alcohol infraction and who may not even meet the criteria for someone with alcohol dependence. This further illustrates the point that, due to the explicit rules of belonging to the profession, we are held to higher standards than the general legal standards of the population.

I’m not saying these things to be arrogant. It’s a simple statement of fact of any true profession, and I’m basing this on coursework I had in social work originally, not medicine.

[dantay]

Originally Posted by Panda Bear

No. You're just being a tool.

Blow me

(illustrating professional behavior )

[Zummy]

What about infidelity and having affairs, and I'm talking about with people we are NOT colleagues with or people who work in the hospital.

Would it be considered "unprofessional" to be seen out in public with your mistress/mister? LOL

[humuhumu]

Originally Posted by Alexander Pink, M.D.

Life is too damn short to worry about what people are gonna think about what you say or your sense of humor. The benefits that come with being in a democratic capitalism are those freedoms to live your life as you please as long as you aren't harming others. I don't say anything on here I wouldn't also say in real life, but of course I say some crazy $hit in real life too. I think that the entire idea of professionalism is debatable because it is hard to pin down what a professional is. I agree you ought not act idiotic, drinking and what not, but that is because I generally think people ought not act stupid in public or private life. Everyone should just exercise a modicum of control over their behavior in all situations and then we wouldn't need such ridiculous distinctions.

My thoughts exactly.

[lil pook]

only if they are clearly a hooker

[yellowcat322]

Originally Posted by MattD

Explain? In what way is driving under the influence even moderately more or less acceptable based on what group you're a member of? It's dangerous and immoral regardless of whether you're the guy who cured cancer or the guy who picks up that guy's trash. Also, as an engineer myself, I sorta resent the implication that we are somehow professionals of a lower quality, or lower standards. I don't want a drunk designing the bridge I'm driving over any more than I want a drunk cutting out my brain tumor. Professionals in general should be held to a professional standard regardless of their particular career, but there's no reason to think being a physician somehow magically makes you special or of a higher status than others.

It's not that a physician has a higher status than other professionals, it's just that physicians have more reasons to maintain a certain character and image of professionalism. This is due solely to the nature of the work. Patients want to know that the person who'll be hearing their most embarassing and private issues, seeings them naked and prescribing them medication is someone who is a respectable and professional person. Taking away the inherent danger of DUI, which is present no matter who is driving, a DUI is potentially more devastating to a physician's professionalism because is undermines the basic trust that patients have in his/her character.

I don't believe that once you're in medicine you have to watch your every word and move. I think it's wrong what that med school did about the blog. WE are still human beings and have the same frustrations and should be allowed to express them like anyone else. It is still your life and your profession is only a part of it. Nevertheless, I do agree that medicine is not just a job. It involves a certain responsibility because of the sensitive nature of your relationships with your patients. That responsibility is something to consider as part and parcel of entering this profession.

[gregMD]

Originally Posted by yellowcat322

It's not that a physician has a higher status than other professionals, it's just that physicians have more reasons to maintain a certain character and image of professionalism. This is due solely to the nature of the work.

for christ sakes - we're doctors, not the f'n president...


for those of you who think that doctors have to be the pinnacle shining stars of responsibility and professionalism - get over yourselves!

[tupac_don]

Originally Posted by gregMD

for christ sakes - we're doctors, not the f'n president...


for those of you who think that doctors have to be the pinnacle shining stars of responsibility and professionalism - get over yourselves!

Hey even the president gets a BJ here and there

[gregMD]

Originally Posted by tupac_don

Hey even the president gets a BJ here and there

a man's got needs - what more can i say?

[yellowcat322]

Originally Posted by gregMD

for christ sakes - we're doctors, not the f'n president...


for those of you who think that doctors have to be the pinnacle shining stars of responsibility and professionalism - get over yourselves!

If you don't think that being a physician and gaining the trust of your patients means that you're somewhat more responsible for your character and professionalism, that's your choice. I believe what I believe and there is nothing wrong with wanting to maintain a standard of professionalism that I think should be inherent to the field of medicine.

[YouDontKnowJack]

outside the workplace, i'd rather take the stick out of my anus.