, Medical Professionalism Best Practices Edited by Richard L. Byyny, MD Maxine A. Papadakis, MD Douglas S. Paauw, MD 2015 Alpha Omega Alpha Honor Medical Society Menlo Park, California A A 1902 Medical Professionalism Best Practices Edited by Richard L. Byyny, MD Maxine A. Papadakis, MD Douglas S. Paauw, MD 2015 Alpha Omega Alpha Honor Medical Society Menlo Park, California i Dedicated to the members of Alpha Omega Alpha Honor Medical Society and the medical profession Publication of this monograph was funded by a President’s Grant from the Josiah Macy Jr. Foundation. Medical Professionalism: Best Practices Edited by Richard L. Byyny, MD; Maxine A. Papadakis, MD; Douglas S. Paauw, MD © 2015, Alpha Omega Alpha Honor Medical Society ISBN: 978-0-578-16071-9 eBook ISBN: 978-0-578-16072-6 ii Contributors Richard L. Byyny, MD (AΩA, University of Southern California, 1964), is the Executive Director of Alpha Omega Alpha Honor Medical Society, and was previously Professor of Medicine at the University of Colorado School of Medicine. From 1997 through 2005, Dr. Byyny served as the Chancellor of the University of Colorado at Boulder. Contact Dr. Byyny at: Alpha Omega Alpha, 525 Middlefield Road, Suite 130, Menlo Park, California 94025. E-mail: [email protected]. Anna Chang, MD (AΩA, St. Louis University, 2000), is Associate Professor of Medicine in the Division of Geriatrics, Department of Medicine, at the University of California, San Francisco, School of Medicine. Contact Dr. Chang at: University of California, San Francisco, School of Medicine, 3333 California Street, Laurel Heights, Room 380, San Francisco, California 94118. E-mail: [email protected]. William O. Cooper, MD, MPH, is Cornelius Vanderbilt Professor and Associate Dean for Faculty Affairs at Vanderbilt University School of Medicine and the Director of the Vanderbilt Center for Patient and Professional Advocacy. Contact Dr. Cooper at: Center for Patient and Professional Advocacy, Vanderbilt University medical Center, 2135 Blakemore Avenue, Nashville, Tennessee 37212-3505. E-mail: william. [email protected]. Richard M. Frankel, PhD, is Professor of Medicine and Geriatrics at the Indiana University School of Medicine, Director of the Mary Margaret Walther Program in Palliative Care Research and Education at the IU/ Simon Cancer Center, and Associate Director of the VA HSR&D Center for Health Information and Communication. Contact Dr. Frankel at: Veterans Administration Medical Center, Room 11 HSR&D, 1481 West 10th Street, Indianapolis, Indiana 46202-2884. E-mail: [email protected]. Suely Grosseman, MD, PhD, is Professor of Pediatrics at the Federal University of Santa Catarina (Brazil). Contact Dr. Grosseman at: Universidade Federal de Santa Catarina—Campus Reitor João David Ferreira Lima Centro de Ciências da Saúde, Departamento de Pediatria Florianópolis, Santa Catarina, Brasil CEP: 88040-900. E-mail: sgrosse- [email protected]. Gerald B. Hickson, MD, is Assistant Vice Chancellor for Health Affairs and Senior Vice President of Quality, Safety and Risk Prevention at Vanderbilt University School of Medicine. Contact Dr. Hickson at: Quality and Patient Safety, 2135 Blakemore Avenue, Campus Zip 8627, Nashville, Tennessee 37212. E-mail: [email protected]. Catherine R. Lucey, MD (AΩA, Northwestern University, 1980), is Professor of Medicine and Vice Dean for Medical Education at the iii University of California, San Francisco, School of Medicine. Contact Dr. Lucey at: University of California, San Francisco, School of Medicine, Box 0410, 521 Parnassus Avenue, Clinic Sci Room 254, San Francisco, California 94143. E-mail: [email protected]. Dennis H. Novack, MD (AΩA, Drexel University, 2001), is Professor of Medicine and Associate Dean of Medical Education at Drexel University College of Medicine. He is a 2011 recipient of the AΩA Robert J. Glaser Distinguished Teacher Award. Contact Dr. Novack at: Drexel University College of Medicine, 2126 Fairmount Avenue, Philadelphia, Pennsylvania 19130. E-mail: [email protected]. Douglas S. Paauw, MD (AΩA, University of Michigan, 1983), is Director, Medicine Student Programs, Professor of Medicine, and Rathmann Family Foundation Endowed Chair in Patient-Centered Clinical Education at the University of Washington School of Medicine. He is a 2001 recipi- ent of the AΩA Robert J. Glaser Distinguished Teacher Award, President of the Board of Directors of Alpha Omega Alpha, and AΩA councilor at the University of Washington. Contact Dr. Paauw at: University of Washington School of Medicine, Department of Internal Medicine, Box 356420, 1959 NE Pacific Street, Seattle, Washington 98195-6420. E-mail: [email protected]. Maxine Papadakis, MD (AΩA, University of California, San Francisco, 1993), is Professor of Medicine and Associate Dean for Students at the University of California, San Francisco, School of Medicine. She was member of the Board of Directors of Alpha Omega Alpha from 2005 through 2007. Contact Dr. Papadakis at: University of California, San Francisco, School of Medicine, 513 Parnassus Avenue, S-245, San Francisco, California 94143-0454. E-mail: [email protected]. Sheryl A. Pfeil, MD (AΩA, Ohio State University, 1984), is Associate Professor of Clinical Internal Medicine and Medical Director of the Clinical Skills Education and Assessment Center at Ohio State University College of Medicine. She is a member of the Board of Directors of Alpha Omega Alpha and the AΩA councilor at Ohio State. Contact Dr. Pfeil at: Ohio State University, Division of Gastroenterology, Hepatology and Nutrition, 395 W. 12th Avenue, Suite 200, Columbus, Ohio 43210. E-mail: [email protected]. Rebecca Saavedra, EdD, is Vice President of Strategic Management in the Office of the President, and Co-Chair of the UTMB Professionalism Committee. Contact Dr. Saavedra at: The University of Texas Medical Branch at Galveston, Office of the President Mail Route 0127, 301 University Boulevard, Galveston, Texas 77555-0127. E-mail: rsaavedr@ utmb.edu. Jo Shapiro, MD (AΩA, George Washington University, 1980), is iv Associate Professor of Otolaryngology at Harvard Medical School and Director of the Center for Professionalism and Peer Support and Chief of the Division of Otolaryngology in the Department of Surgery at Brigham and Women’s Hospital. Contact Dr. Shapiro at: Brigham and Women’s Hospital, Division of Otolaryngology, 45 Francis Street, ASB-2, Boston, Massachusetts 02115. E-mail: [email protected]. George Thibault, MD (AΩA, Harvard Medical School, 1968), has served as the President of the Josiah Macy Jr. Foundation since 2008. He is the Daniel D. Federman Professor of Medicine and Medical Education, Emeritus, at Harvard Medical School. He was previously Vice President of Clinical Affairs at Partners Healthcare System in Boston and Director of the Academy at Harvard Medical School. Contact Dr. Thibault at: The Josiah Macy Jr. Foundation, 44 East 64th Street, New York, New York 10065. E-mail: [email protected]. Deborah Ziring, MD, is Assistant Professor in the Department of Medicine at Drexel University College of Medicine. Contact Dr. Ziring at: Drexel University College of Medicine, 2900 Queen Lane, Room 221, Philadelphia, Pennsylvania 19129. E-mail: [email protected]. v vi Acknowledgments Thanks to Dr. John A. Benson, Jr. (AΩA, Oregon Health & Science University, 1968), and Dr. Jack Coulehan (AΩA, University of Pittsburgh, 1969), who serve on AΩA’s Professionalism Award Committee and on the editorial board of The Pharos, for their help in reviewing and improving this monograph. We thank the Josiah Macy Jr. Foundation for its President’s Grant, which funded the publication and distribution of this monograph. vii viii Table of Contents Dedication........................................................................................................... ii Contributors ....................................................................................................... iii Acknowledgments ............................................................................................. vii Preface. Medical Professionalism: Best Practices Richard L. Byyny, MD ....................................................................................... xi Introduction ........................................................................................... Chapter . Introduction Maxine Papadakis, MD ............................................................................... Chapter . The Problem with Professionalism Catherine R. Lucey, MD ............................................................................... Chapter . Current Practices in Remediating Medical Students with Professionalism Lapses Deborah Ziring, MD, Suely Grosseman, MD, PhD, and Dennis Novack, MD ........................................................................... Models ..................................................................................................... Chapter . Review of Current Models for Remediation of Professionalism Lapses Sheryl A. Pfeil, MD, and Douglas S. Paauw, MD ..................................... Chapter . Cultural Transformation in Professionalism Jo Shapiro, MD ............................................................................................... Chapter . Enhancing Interprofessional Professionalism: A Systems Approach Rebecca Saavedra, EdD ................................................................................ Chapter . Pursuing Professionalism