Professional Values Discussions with Colleagues
The Importance of Discussions of Professional Values Among Doctors in GMC Cases
Shared professional values are an important aspect within medicine. They are shared by doctors, nurses, and other clinical practitioners and lay people allied to medicine. While there may be some differences between the professions, based on their respective roles, there will still be core values that are shared by all, such as the need to act with integrity.
Doctors who are facing GMC fitness to practise proceedings should ideally undertake discussions with their peers about professional values, with a focus on the matters that are of concern to the GMC: what went wrong for them, or what was deficient in their practice or personal life, that led to the concerns being raised.
A doctor might be prosecuted in the criminal courts for drink driving, or domestic violence; or make clinical errors or errors of judgment in medicine. They might attend work while unfit due to ill-health, causing a risk of harm to others. The ways in which a doctor can fall below the standards expected of them can be wide-ranging and numerous, but all clinicians will need to work to the shared professional values expected of them.
Some of those values are adumbrated in the professions’ codes of conduct, such as Good Medical Practice (for doctors). Yet, the codes are not the only litmus test or standards for measuring good conduct. There will, on occasions, be shared values that are not expressly stated in the codes of conduct – perhaps more nuanced in a given situation – but which all doctors will still need to adhere to in a given situation. There may be an overlap with organisational values, too. Such professional values will often apply whether working collaboratively or autonomously.
Who to have the discussion with
It is important to choose appropriately qualified people, of sufficient seniority, for the exercise to be worthwhile. They do not need to be specialist educators or tutors, as the exercise is about speaking to fellow professionals in the same area of practice.
Peer discussion is deemed to be an important aspect of remediation, and the demonstration of insight. Such discussions should therefore include a focused analysis of the subject matter that has led to the referral to the GMC. This does not require a detailed root-cause analysis, albeit that can be of help in identifying features of the concerns that require remediation; but certainly an analysis of the professional acts or omissions that would likely not be supported by a reasonable body of registered medical practitioners would be necessary.
Content of Discussions
During such discussions, a doctor does not need to accept the validity of the concerns raised (the allegations) to be able to talk in-depth about what is expected of a doctor in a professional context, while bearing in mind and touching on the subject matter of the alleged conduct. They can still say, “if a doctor were to have done X, they would need to demonstrate E,F, G, and it would have been suboptimal or inappropriate to have conducted oneself in X (above) way. It can be useful, too, to focus on the development of insight, by using the flowchart on our other page: How to Show Insight in GMC Cases
The GMC and MPT tribunals can be critical of doctors who do not undertake this step as part of the process of remediation.
What are professional values? There may be broad consensus on some professional values, and less consensus on others. But what are the core-values of a professional? What do professionals expect of one another? What do employers expect of professionals? What do the public require of professionals? These are all questions that the peer discussion should include in a general sense, and with a focus on the conduct of concern. One helpful question to ask oneself is: What is it to be a professional?
Academic Identification of Professional Values:
‘Both the personal and professional values of healthcare practitioners may influence their decisions on patient care (Gross and Robinson 1987; Smith et al. 1991). Personal values guide people’s behaviour and choices in their lives as individuals (Rokeach 1973; Schwartz 1992), whilst professional values guide their behaviour as a member of an occupational group (Eddy et al. 1994). Professional values are deliberately selected by the occupation as those values that shape the group’s identity, principles and beliefs (Frankel 1989). These values enjoy high consensus on their importance within the group, and are generally defined within their code of ethics (Frankel 1989; Hussey 1996).’
Healthcare practitioners’ personal and professional values. Mpatisi Moyo et al. , Adv in Health Sci Educ (2016) 21:257–286 DOI 10.1007/s10459-015-9626-9. (If you download the article, you can find a list (in table 2) of some of the common professional values that doctors have identified. However, it is not necessary to download this document (as they charge a fee), to be able to undertake the focussed discussion.