1- COMMED- Intro, Leadership and Professionalism

Community Medicine

EVALS # 1

Lecture #1: Leadership and Professionalism

Occupational Medicine

Lecture Content/Table of Contents

1.

The branch of medicine that deals with the

1.

DEFINITION OF TERMS

2.

LEADERSHIP

3.

TEAMWORK

4.

PROFESSIONALISM

injuries occurring at work or in specific

5.

UNPROFESSIONAL BEHAVIORS

occupations.



prevention and treatment of diseases and

 Occupational

DEFINITION OF TERMS

Disease is

one

that

is

associated with a particular occupation and Table I. Clinical Medicine vs. Public Health

CLINICAL MEDICINE Primary focus on individual

Primary focus on population

Test individual patients oneby-one

Monitor and diagnose the health concerns of entire communities

Emphasis on diagnosis and treatment

Emphasis on medical care

providing

Lines of specialization organized, for example by: Organ system 

Emphasis on prevention and health promotion for the whole community



Patient group

Occupational Health 

Lines of specialization organized, for example by: Analytical method  (epidemiology) 

Promotion and maintenance of the highest degree of physical, mental, and social wellbeing of workers in all occupations by preventing

departures

from

health,

controlling risks and adaptation of work to people, and people to their jobs 

The

goal

is

to

foster

a

safe

work

environment. 

Setting and

It may also protect co-workers, family members, employers, customers, suppliers,

(pediatrics)

population

Etiology,

(occupational

nearby communities, and other members of

pathophysiology

health)

the public who are impacted by the

Substantive health

workplace environment.

(oncology,



infectious disease) 

Ex: Some occupations confer specific risks, such as the prevalence of black lung in coal miners.

Emphasis on prevention and health promotion for the whole community

(cardiology) 

occurs in the workplace.

PUBLIC HEALTH

Technical skill (radiology)

problem (nutrition) 



Skills in

from health hazards in the workplace

assessment, policy development, and

Identification and assessment of the risks



Advising on planning and organization of work and working practices, including the

assurance

design

of

work-places,

and

on

the

evaluation, choice and maintenance of Family Medicine 

Specialty that provides comprehensive and

equipment and on substances used at work. 

education, on occupational health, safety

ongoing medical care to all members of the

and

family unit. 

Diagnosis and treatment of general medical concerns for children, adolescents, and adults; provides health care regardless of

Providing advice, information, training and hygiene

and

on

and

protective

equipment. 

Surveillance of workers' health in relation to work.

Community Medicine

EVALS # 1

Lecture #1: Leadership and Professionalism



From a sociological perspective, refers to a

Preventive Medicine

group of people united by at least one 

common characteristic o

preventing to disease rather than curing it.

geography, shared interests, values, 

experiences, or traditions.



 





New Definition:  The specialty that focuses on health in order to protect, promote and

Community Medicine 

Is the part of medicine engaged with

maintain health, and prevent disease,

Branch of medicine; new specialty Requires special knowledge of epidemiology, organization and evaluation of medical care, and the medical aspects of health service administration. Distinct from Public Health Interest is centered in the community as a whole and the groups of which communities are composed Comprises those doctors who try to measure the needs of the population, both sick and well, who plan and administer services to meet those needs, and those who are engaged in research and teaching in the field. Through inter-disciplinary and inter-sectoral partnerships, the Community Medicine specialist measures the health needs of populations and develops strategies for improving health and well-being, through health promotion, disease prevention and health protection.

disability and premature death. 

For both infectious disease and chronic disease.



Understanding and reducing the risks of disease, death, and disability

LEVELS OF PREVENTION: o

Primary

activities) refers to the avoidance of disease occurrence as well as actions taken before disease onset. Ex:  immunizations, fluoridation o

Secondary prevention refers to the

Done through organized community effort for the: control of communicable infections, Sanitation of the environment, organization of medical and nursing services for the early diagnosis and prevention of disease.

and

health. The development of the social machinery to assure everyone a standard of living for

the

improvement of health.

maintenance

o

Tertiary prevention refers to the limitation or reduction of disability, when disease has already occurred, through rehabilitation designed to encourage recovery and prevent

Education of the individual in personal

adequate

(detection)

Ex: hypertension, cholesterol screening, programs that encourage self-assessment for cancers.

The science and art of: disease prevention, well-being.



diagnosis

avoidance of disability.

prolonging life, and promoting health and



water

prompt treatment of disease and the

Public Health



(often

operationalized in health promotion

early



prevention

further problems. Ex: cardiac rehabilitation programs, occupational therapy for individuals with a variety of physical disabilities.

or Environmental Health

Community Medicine

EVALS # 1

Lecture #1: Leadership and Professionalism



Includes both the direct pathological effects of chemicals, radiation and some biological agents, and the effects (often indirect) on health and wellbeing of the broad physical, psychological, social and aesthetic environment which includes housing, urban development, land use and transport.



make decisions without consulting their team members, even if their input would be useful.



appropriate when you need to make decisions quickly, when there's no need for team input, and when team agreement isn't necessary for a

2. LEADERSHIP

successful outcome. LEADERSHIP •

•

•

•



is creating and ‘making happen what wouldn’t otherwise happen’. getting significant new things done. (I&DeA, 2003) is the process of influencing others to understand and agree about what  needs to be done and how it can be done effectively, and the process of facilitating individual and collective efforts to accomplish the shared objectives. (Yukl, 2002: 7)

to high levels of absenteeism and staff turnover. 2. Democratic Leaders 



Motivates and inspires people to Manages delivery of the vision.

o

Coaches and builds a team, so that it is more effective at achieving the vision.



encourage creativity, and people are

team members tend to have high job satisfaction and high productivity.



not always an effective style to use when you need to make a quick decision.

3. Laissez-faire Leaders 

give their team members a lot of freedom in how they do their work, and how they set their deadlines.

 Management:  is the effective handling of

complex situations and demands to deliver

the

decisions.

engage with that vision. o

members  in

often highly engaged in projects and

future. o

team

decision-making process.

following: Creates an inspiring vision of the

make the final decisions, but they include

an effective leader is a person who does the o

can be demoralizing, and it can lead



provide support with resources and advice if needed, but otherwise they

what should be happening.

don't get involved. 

can lead to high job satisfaction , but it can be damaging if team members don't manage their time well, or if they don't have the knowledge, skills, or self motivation to do their work effectively.

3. TEAMWORK TEAMWORK

Community Medicine

EVALS # 1

Lecture #1: Leadership and Professionalism



Encourages multi-disciplinary work where teams cut across organizational divides.



Fosters

flexibility

and

responsiveness,

especially the ability to respond to change. 

Pleases customers who like working with good teams (sometimes the customer may be part of the team).



Promotes the sense of achievement, equity and camaraderie, essential for a motivated workplace.



When managed properly, teamwork is a better way to work!

Table II. Group Patterns

Storming

Norming

Performing

Adjourning

A. POSITIVE ROLES  Initiator-Coordinator: Suggests new ideas or

new ways of looking at the problem.  Elaborator: Builds on ideas and provides

examples.  Coordinator: Brings ideas, information, and

suggestions together.  Evaluator-Critic:

Evaluates

ideas

and

provides constructive criticism.  Recorder:

Records

ideas,

examples,

suggestions, and critiques.

GROUP PATTERNS

STAGES Forming

ROLES IN A GROUP

B. NEGATIVE ROLES ACTIVITIES Members come together, learn about each other, and determine the purpose of the group. Members engage in more direct communication and get to know each other. Conflicts between group members will often arise during this stage. Members establish spoken or unspoken rules about how they communicate and work . Status, rank and roles in the group are established. Members fulfill their purpose and reach their goal. Members leave the group.

 Dominator:  Dominates

discussion,

not

allowing others to take their turn.  Recognition Seeker: Relates discussion to

their accomplishments, seeks attention.  Special-Interest: Pleader relates discussion

to special interest or personal agenda.  Blocker:  Blocks

attempts at consensus

consistently.  Joker or Clown: Seeks attention through

humor and distracts group members. 4. PROFESSIONALISM  PROFESSION: vocation or ‘calling’,

especially one involving a degree of skill, learning or science; “a trade or occupation pursued for higher motives, to a proper standard ”. Table IV. Professional vs. Amateur

THE LIFE CYCLE OF MEMBER ROLES Table III. The Life Cycle of Member Roles

PROFESSIONAL -Someone who earns a living from their trade or occupation. -‘Professional’ performance is one which is good, polished

AMATEUR -Someone who might do the same or a similar thing, but without remuneration -‘Amateurish’ performance is the opposite  –  however

Community Medicine

Lecture #1: Leadership and Professionalism 2) Accountability:

answerable

being

to

EVALS # 1

to a patient an acceptable

patients, society and profession.

standard of respectability.

3) Excellence: conscientious effort to perform beyond

ordinary

expectation,

and

commitment to life-long learning.

 RESPONSIBILITY AND RELIABILITY o

promises.

4) Duty: free acceptance of commitment to service  –  i.e. undergoing inconvenience to

Honoring commitments and keeping

o

Ensuring that tasks and duties are

achieve a high standard of patient care.

completed and addressed, by taking

5) Honor and integrity: being fair, truthful,

the initiative and leading by example

straightforward, and keeping to one’s work. 6)

o

a lack of immediate attention to your

Respect for other: respect for patients and

duties can be the difference between

families,

life and death.

colleagues,

other

healthcare

professionals and students and trainees.  PROBITY

Characteristics of a Professional  TRUST o

o

Latin for good, honest and upright.

o

fair, law-abiding and of general good character.

creates the foundation stone of the doctor –patient relationship.

 CONDUCT o

 EXPERTISE o

medical professional.

A professional person is expected to have a particular set of skills in their chosen field, at a level that can be

 RESPECT o

considered expert. o

acquired

learning,

through

o

dignity and autonomy of others.

demonstrated by qualifications or

 HONESTY AND INTEGRITY o

 STANDARDS o

law-abiding, and respectful of the

have the ability and dedication to achieving a set of standards in their that

their

peers

find

acceptable.  RESPECTABILITY o

Expectations that a professional will work and behave in a manner that is appropriate to the nature  of their

Define how any professional person should act: being upstanding and

A professional person is expected to

duties

aim to be courteous and should at the very least respect the rights,

the relevant skills and, in most cases. accreditation of some kind.

Respect for authority and the rule of law.

knowledge, training and practice of o

correct behavior and conduct of a

trust placed in you by others. o

Especially important in the following situations:  Writing your CV  Preparing medical reports  Record-keeping  –  medical

records

should

be

contemporaneous and not retrospectively altered in the

Community Medicine

Lecture #1: Leadership and Professionalism

EVALS # 1

truthful when giving a spoken or written statement, you must be honest about the limitations of your knowledge

• • • •

Role Modeling Bed Side Teaching Simulated Patients Small Group Discussions

and competence  Research  SOCIAL RESPONSIBILITY o

must possess a strong sense of empathy, a desire to do good  – and this can be broadly described as having a social responsibility.

o

This might include:  Compassion

for

those

suffering pain and hardship  A proper and responsible role

Figure II. Unique Elements from the Different Focus Groups

in society  A responsible attitude to the

 What are traits that can contribute to the

success of a team?

environment (especially in relation to the management



Honesty/integrity

of clinical and hazardous



Selflessness

waste, the use of energy and



Dependability

raw materials)



Enthusiasm

 Good employment practices



Responsibility

(in the case of self-employed



Cooperativeness

GPs or doctors working in



Initiative

private practice)



Patience

 An awareness of social issues



Resourcefulness

where the medical profession



Punctuality

is in a position to play an



Tolerance/Sensitivity



Perseverance

important or central role (eg, physical abuse in all its forms,

ROLES AND RESPONSIBILITIES IN A GROUP

discrimination, etc) 

Team Leader



Team Recorder

proving



Team Quality Advisor

assistance in an emergency



Team Member

 Humanity

in

both

professional and personal matters

(eg,

situation, a Good Samaritan act)  Adherence to the law (eg, in

relation to substance abuse,

 For a team to be successful, the following

characteristics are needed: 

A clear direction that is understood by all team members

Community Medicine

Lecture #1: Leadership and Professionalism and protected from the very start of



the person lacks the necessary training,

to medical school.

expertise or competence 

• • •

Arriving for class late and/or leaving early Being unprepared for group sessions Not completing assigned tasks Disrupting class sessions Failing to attend scheduled class sessions

Examples of Unprofessional Behaviors Classroom Setting-Students/Trainee

Being resistant to feedback or maintaining one’s continuing professional development



•

Agreeing to undertake a procedure for which

a professional career, including entry

Examples of Unprofessional Behaviors Classroom Setting-Students/Trainee •

EVALS # 1

Laziness, sloppiness or a lack of attention to detail.

Signs and Symptoms Project Professionalism (ABIM, 2001)

1) Abuse of power: abuse while interacting with patients and colleagues; bias and sexual harassment; and breach of confidentiality.

• • • • • •

Cheating on an exam Using Mobile Phone during class Chatting during class Focusing on the test vs. learning Prejudging content in advance Intolerance of the opinions of others

2) Arrogance: offensive display of superiority and self-importance. 3) Greed: when money becomes the driving force. 4) Misrepresentation: o

Examples of Unprofessional Behaviors Classroom Setting-Faculty

truth o

• • • • • •

Plagiarism Judgmental attitude or favoritism Coming late Sloppy handouts and syllabi Abusive behavior Using Mobile Phone during class

Examples of Unprofessional Behaviors: Clinical SettingStudents

Lying: consciously failing to tell the Fraud: conscious misrepresentation of material fact with the intent to mislead.

5) Impairment: any disability that may prevent the physician from discharging his/her duties. 6) Lack of conscientiousness: failure to fulfill responsibilities. 7) Conflicts

• • • •

•

• • •

interests:

self-promotion/

Dressing inappropriately Avoiding work and/or responsibilities Exhibiting little empathy for patients Demonstrating lack of sensitivity to patients’ cultural backgrounds

advertising or unethical collaboration with

Not protecting patient confidentiality

patients.

Examples of Unprofessional Behaviors: Clinical Setting: Faculty •

in

Showing favoritism Failing to attend scheduled sessions Using inappropriate language or behavior Asking learners to perform personal tasks, for example, picking up laundry

industry; acceptance of gifts; and misuse of services  –  overcharging,

inappropriate

treatment

contact

or

prolonging

Reference:  Dr. C. Hipol’s lecture and ppt.  Recordings

with

TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO, AIANNE REYES, SUBTRANSHEAD: RJ BELTRAN

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TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO, AIANNE REYES, SUBTRANSHEAD: RJ BELTRAN

9 of 7