What it Means to Become Members of a
Profession
by Bruce Blank DPM
Private Practice, Martin Ferry, Ohio
Eighteen
years ago, when I graduated from residency training, I'm not sure if
I understood what being a member of a profession really meant. I
wanted to become the best healer I could be, to become a respected
member of my community and to make a difference in peoples lives.
When
258 senior residents were surveyed about the meaning of
professionalism, they listed the same three attributes:
competence, respect, and empathy.
Those
are important aspects of what it means to be a professional.
In
the literature, it is generally agreed that four criteria must be
met before society grants professional status to an occupation, as
it has for the practice of medicine
|
1.
The practice of a
profession must rest on a systematic body of knowledge of
substantial intellectual content
2.
There
is a prescribed way of entering the profession through the
enforcement of minimum standards of training and competence
3.
There must exist standards of
professional conduct which take precedence over the goal of
personal gain |
Now,
here's the fourth, a little more elusive than the first three, but
just as important:
| 4.
A
profession has its own association of members, among whose
functions are the enforcement of standards and the
advancement and dissemination of knowledge. |
It is
this fourth criterion that I wish to discuss with you today.
Once
society grants an occupation the status of a profession, the
profession is also granted self governance. But with that comes a
very important obligation. In a lecture to the 109th Annual Meeting
of the Association of American Medical Colleges, Dr. Richard L.
Cruess described it this way
Physicians must have a clear understanding of what it means to be a
professional as well as a healer, and what obligations they must
fulfill to justify their professional status. Medicine was granted a
broad monopoly over health care and considerable autonomy. These
privileges were accorded with the clear understanding that in return
the medical profession would concern itself with the health problems
of the society it served and place the welfare of that society above
its own
He
goes on to say, While each individual professional is expected to
act for the benefit of society, it is the professional association
that is responsible for setting and maintaining standards, self
regulation, developing codes of ethics, and informing the public and
legislative authorities on matters within their expertise.
He
concludes that support of these organizations and their activities
thus becomes one of the obligations of a professional.
After
graduation from residency, I hope you will want to join the APMA and
your State component society so you can be a part of the group on
the inside that makes things happen. These are the groups that will
propel our profession forward sometimes against the wishes of those
who would rather keep us from taking our well-earned and
well-deserved place in the medical community. I knew it was
important to join, but the longer I've been a member, the more I've
come to realize that being a member of your podiatric medical
association, or the fourth criterion, is indeed one of the
obligations of being a professional.
A
doctor is both a healer and an advocate for his patients. Without
being a member of our profession, it is harder to be the best healer
you can be but virtually impossible to be the best advocate. I
wasn't in practice very long before I began to learn why.
When
I first entered practice in a part of Ohio where there were not many
newly trained podiatrists, I hit a brick wall with one of the
largest insurers in the area. Podiatric physicians were not
authorized by them to perform any bone surgery other than hammer toe
correction; so, many patients were left to live with a variety of
painful conditions. Being a member of my professional association,
having other members to advise me and personally speak to the
insurer on behalf of podiatric medicine is what helped to eventually
change the rules. Podiatrists may now perform surgery throughout the
foot and ankle for their patients who are insured by that company.
Examples of other situations where many of our State Associations
have, or our National Association has, had successes are: inclusion
of the ankle in scope of practice; fighting the optional services
issue to keep DPMs as providers for Medicaid patients; passage of
laws to allow DPMs to independently admit patients to hospitals; and
fighting unfair contracting by insurance companies.
Your
association leaders today were no different from you when they
crossed the threshold from residency to practicing podiatric
physician. They are not somehow blessed with an unnatural ability to
take on the additional tasks of advocacy and service while the rest
of their colleagues concentrate on their daily work in the office.
They too have a practice to run, patients to see in the hospital,
families to care for, and personal responsibilities. What they do
have, and what every member of your professional association
possesses, is a commitment to the fourth criterion: being a part of
their professional association. Even when we disagree, we need to
look past an issue that divides, focus on the potential for good,
and work toward changes from the inside.
Whatever your role becomes in
your state and national associations, supporting them by your
membership is one of the ways by which you fulfill the obligations
you are accepting when you step into practice. You can only support
your profession by being a member. Professional dues should never be
considered an option, but a practice expense as basic and necessary
as rent and utilities. The dividends for you and your patients cant
effectively be measured.
