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Table 3 Representative quotes from interviews with faculty and patients

From: Assessment of medical professionalism: preliminary results of a qualitative study

Sub-domain

Faculty

Relevance

Patient

Relevance

Quotation

Quotation

Domain: Doctor-patient relationship skills

Listened actively to patient

Professional doctors must be good listeners, the opportunity for the family or the patient to get things off their chest is very important.

– Faculty, 38 years old, Female, Indian

+

As a doctor, I feel that you should not cut the patient short.

- Patient, 23 years old, Male, Chinese

+

Showed interest in patient as a person

A professional doctor should not treat the disease only but treat the patient as a whole, and look at the patient as a whole, as a person, as a person like a family in the community.

- Faculty, 50 years old, Male, Chinese

+

Rather than just seeing the patients as just someone [who needs to be] diagnosed, it is important to see them as individuals who have emotions.

- Patient, 23 years old, Female, Indian

+

Recognized and met patient needs

A professional doctor needs to find from the patient what they want, how can we help them overcome the disease condition as much as possible.

- Faculty, 50 years old, Male, Chinese

+

Doctors should listen to what the patients want, not [just provide] what they want for the patients.

- Patient, 30 years old, Female, Chinese

+

Extended his/herself to meet patient needs

[When parents refused admission], we offered alternative [transfer to another institution], and when they didn’t accept that, our next step was [getting] social worker to visit, speak to the parents, see how they could help.

- Faculty, 43 years old, Male, Indian

+

Doctors do go beyond what they are supposed to do. They contact social services to help arrange for patients to make sure that they are compliant to their medications, because otherwise there is no point in treating them if they are not compliant.

- Patient, 28 years old, Female, Chinese

+

Going above and beyond, I think it’s just icing on the cake. I think also has to be taken in context because sometimes patients or family may have needs that are beyond our ability to actually fulfil, or sometimes it may not actually be appropriate.

-Faculty, 37 years old, Female, Chinese

Everyone is really busy and only have certain amount of time with the patient, I think that as long as you do your job, like you try to understand the patient and meet the patient needs, that’s good enough.

-Patient, 30 years old, Female, Chinese

Ensured continuity of patient care

Professional doctor will refer patients to relevant colleagues in the other specialty.

- Faculty, 50 years old, Male, Chinese

+

Doctor can refer patients to specialist in that field.

- Patient, 24 years old, Female, Chinese

+

Advocated on behalf of a patient

If the patient needs financial assistance, a doctor should know about that, and initiate referral.

- Faculty, 42 years old, Female, Chinese

+

The doctor advocated for my mother to get some form of subsidy because it’s a very expensive surgery … I think she stayed for 1 month in the ICU, so the cost is very high. It’s actually quite heartening that the doctor care about your financial concern, not just about performing the surgery and saving your life.

- Patient, 30 years old, Male, Chinese

+

Healthcare professionals should try to advocate patients to help their own, not just rely on the healthcare professionals, the doctors.

- Faculty, 27 years old, Female, Chinese

Not applicable

 

Maintained appropriate boundaries

Doctors need to be sensitive to religion and culture, and not say something or do something which will be culturally taboo.

- Faculty, 49 years old, Male, Chinese

+

A professional doctor maybe [mean] keeping things professional, keeping a distance from the patients unless necessary.

- Patient, 24 years old, Female, Chinese

+

Communicates effectively with patient

Trying to explain the clinical scenario, their problems, whatever treatment they undergo, and at the same time, answering their questions, taking them into confidence, making sure that they understand, checking their understanding.

- Faculty, 49 years old, Female, Indian

+

When doctors are explaining the patient’s medical condition, they should use a more layman and general term, to ensure that the patient understand. A professional doctor should stand in the shoes of the patient when explaining the patient’s condition, instead of just bombarding all the medical terms, which some patients may not even understand.

- Patient, 24 years old, Female, Chinese

+

Domain: Reflective skills

Demonstrated awareness of limitations

Trying to do something that you don’t understand is unprofessional. Not asking for help at the right time, not knowing your limits, not knowing the limits of your knowledge and skills is also unprofessional behaviour.

- Faculty, 49 years old, Female, Indian

+

If you are not able to do it, you probably think of referring it to somebody or you talk to somebody.

- Patient, 60 years old, Male, Chinese

+

Admitted errors/omissions

Sometimes during emergency resuscitation situation, there may be lapses. Doctors really have to be brave enough to own up to that mistake, because if you don’t, you may not get corrective action done.

- Faculty, 43 years old, Male, Indian

+

Professional means you must be able to own up to the mistake you make.

- Patient, 32 years old, Female, Malay

+

Solicited feedback

Sometimes there are things that doctors don’t realize so it’s good to get feedback from others to improve yourself.

- Faculty, 26 years old, Female, Indian

+

A doctor needs to listen to other people’s opinions, to reflect whether or not he has this ability to meet the requirements. I think he must listen to others before he can know whether he has met the requirements of a doctor.

- Patient, 55 years old, Female, Chinese

+

If you are a junior doctor, feedback will be given to you, you don’t have to look for it. The faculty are forced to fill up feedback form for them.

-Faculty, 34 years old, Male, Malay

The doctor doesn’t need to solicit feedback actively like ask every single patient whether you have any feedback, any way I can improve myself as a doctor? I feel it is unnecessary.

-Patient, 24 years old, Female, Chinese

Accepted feedback

It’s important to have the humility, to accept people’s feedback, and try to reflect.

- Faculty, 34 years old, Female, Chinese

+

It’s key in the doctor profession, to take feedback, learn from it, and become better.

- Patient, 32 years old, Female, Malay

+

Maintained composure in a difficult situation

If a doctor gets angry because the patient is getting angry, then the doctor is not professional.

- Faculty, 38 years old, Female, Indian

+

Sometimes doctors have to meet some unreasonable patients, or emotional patients, and they have to endure their bad emotions.

- Patient, 70 years old, Female, Chinese

+

Domain: Time management

Was on time

When you are punctual, you are not only respecting yourself, but also the person you are dealing with, for example the patients or sometimes even the colleagues when we are having meeting.

- Faculty, 58 years old, Male, Chinese

+

I feel doctors should be punctual.

- Patient, 52 years old, Female, Chinese

+

Completed tasks in a reliable fashion

The junior doctors have assignments to do, assessments to do, reports to fill. All these should be done in the time allotted to it.

- Faculty, 46 years old, Male, Indian

+

Not applicable

 

Was available to colleagues

A professional doctor will take into account team members’ welfare as well. When we work in a team, we make sure that people are not over-worked, and help colleagues if they need our help.

- Faculty, 38 years old, Male, Chinese

+

Not applicable

 

Only doctors who have done very well have spare capacity to help other colleagues. If they are not good enough, sometimes it is not unprofessional, it is just that they do not have the capacity to help others.

- Faculty, 58 years old, Male, Chinese

Not applicable

 

Domain: Inter-professional relationship skills

Maintained appropriate appearance

Society has got some norms about how they expect doctors to look like. If you dress outside those norms, and because you dress like that make the patients distrust you or worse still distrust the doctors in general, then that is inappropriate.

- Faculty, 46 years old, Male, Indian

+

We would want to see a doctor who is clean and decent.

- Patient, 35 years old, Female, Chinese

+

Addressed own gaps in knowledge and skills

Professional doctor has to show that he has been in keeping up with the technology updates in medicine through on-going continuing medical education courses, go to conferences for updates.

- Faculty, 49 years old, Female, Chinese

+

Professional doctors need to know what are the latest technological advances to help patients better.

- Patient, 28 years old, Female, Chinese

+

Demonstrated respect for colleagues

We should take other healthcare professionals’ opinion respectfully, and consider whether the opinion is correct, or whether they are of certain merit, rather than discount them totally.

- Faculty, 38 years old, Male, Chinese

+

Not applicable

 

Avoided derogatory language

I mean the comments or feedback should be made as objective as possible. You just highlight what your colleague has done wrong and give them advice, rather than saying, “You are lazy” or “You cut corners” and all that.

- Faculty, 38 years old, Male, Chinese

+

Not applicable

 

Maintained patient confidentiality

Confidentiality is of course avery important part of doctor-patient relationship. Not divulging patient’s medical information on social media.

- Faculty, 38 years old, Male, Chinese

+

Not applicable

 

Used health resources appropriately

Making the best use of limited resources to give the patients the best possible things which are consistent with their values would be an independent skill of professionalism.

- Faculty, 46 years old, Male, Indian

+

Not applicable

 

Sometimes certain buffers need to be put in place because unexpected things can happen. I rather be safe and use slightly more resources than to be sorry especially when something unexpected happen.

- Faculty, 50 years old, Male, Chinese

Not applicable

 

Demonstrated collegiality

Giving other colleagues responsibility, so certain departments do not give nurses much responsibilities, even though they have master’s degree in nursing.

- Faculty, 49 years old, Male, Chinese

+

Not applicable

 
  1. + represents relevant
  2. - represents not relevant