Medical professionalism among clinical physicians in two tertiary hospitals, China

Abstract

In order to investigate medical professional attitudes and behaviors in China and explore the influencing factors with a focus on hospital internal management, we developed a 13-item professional attitudes and 11-item behaviors inventory. Self-administered questionnaires were distributed to 390 physicians mainly in four specialties in two tertiary Chinese hospitals in 2011. 306 completed questionnaires were collected. More than 90% of respondents agreed with at least nine of the 13 specific statements about principles. However, responses on behaviors were not necessarily consistent with those on attitudes. 80.3% of respondents reported that they usually or always participated in quality improvement activities and 48.2% reported that they usually or always participated in peer evaluations of colleagues' quality of care. Some 47.8% had encountered incompetent colleagues and 17.7% had encountered significant medical errors caused by colleagues. Among those who had encountered incompetence or significant medical errors, almost two thirds had never reported their concerns to the hospital or other relevant authorities. Half of the physicians did not obtain enough continuing medical education credits. Physicians' professional reported behaviors were influenced by their personal and professional characteristics, professional attitudes, and assessment of hospital internal management constitutions. For example, participation in decision-making had a significant role in professional reported behaviors of protecting patient confidentiality, improving quality of care, and self-regulation, with those sometimes or often participating in decision-making indicating higher levels of reported behaviors than those who seldom participated (odds ratios: 1.84; 4.31, 2.44; 3.31). The results showed Chinese physicians demonstrated positive attitudes to professionalism principles. However, their reported behaviors were at times inconsistent with their attitudes, especially in the areas of competence, quality improvement, and self-regulation. One of effective strategies to facilitate Chinese physicians' professionalism may be to improving hospital management.

Ongoing initiatives to improve prescribing efficiency in China; statins as a case history

“…This would build on current contracting initiatives in hospitals in other districts and settings (31,72). In addition, professionalism must be improved in all aspects of hospital management (73) and perhaps introducing regulations and laws to reduce unethical practices. These could mirror recent regulations and laws in Europe, Korea and the US (6,19,74,75).…”

Assessment of Surgery Resident Competency Provided by Patients

“…These changes make the evolution of professional values more important and have drawn greater attention to these issues. 43 Effective strategies should be proposed to facilitate Chinese physician professionalism, 8 and professional development programs and medical ethics education should not only emphasize the general principles involved but also formulate guidelines on how these principles can be achieved in practice. 44 …”

“…The relationship between the patient and professional has markedly deteriorated over the past decade in China 6–8 due to ineffective communication between the 2 parties. 9 Effective patient–professional communication promotes satisfaction, 10 and most importantly, facilitates patient adherence to treatment regimens.…”

China’s Physician and Nurse Workforce

“…Survey research showed that most Chinese physicians have attitudes consistent with the charter but not necessarily behaviors consistent with the attitudes. 142 For example, while nearly 100 percent of doctors stress the importance of maintaining professional competence, only 75 percent stated they were able to apply new medical knowledge and skills critically. As another illustration, while over 90 percent believe they should actively evaluate the quality of their peers, less than 50 percent report they have participated in such activity.…”