400
n.d. study outcome not defined, Z convenience samples from general population recruited in a hospital setting, Z* convenience samples from general population recruited in a nonclinical setting , Z+ random samples
In most of the studies convenience samples were used. That means that people selected themselves by voluntary participation. The populations marked with “Z” are convenience samples of patients. These people were approached in a hospital setting (in waiting areas or wards). The populations marked with “Z*” are convenience samples of general population; these people were recruited in a nonclinical setting (shopping mall, on the street), therefore they are considered as “general population” even if they may understand themselves as patients too since there is a good chance that most people have made “patient experience” of any kind during their past. The populations marked with “Z+” are random samples.
We were able to summarize the attributes described in the included articles in six different superordinate categories, whose boundaries remain fuzzy: (1) General interpersonal qualities, (2) Communication and patient involvement, (3) Medical competence, (4) Ethics, (5) Medical management, (6) Teaching, research, and continuous education.
Most frequently, attributes of the categories “General interpersonal qualities” ( n = 66) and “Communication and patient involvement” ( n = 59) were mentioned, followed by “Medical competence” ( n = 50), and “Ethics” ( n = 48). “Medical management” ( n = 32) and “Teaching, research, and continuous education” ( n = 28) were least often mentioned. All counts are shown in Table 2 .
Categories and frequency of denomination
Attribute | |
---|---|
General interpersonal qualities | 66 |
Communication and patient involvement | 59 |
Medical competence | 50 |
Ethics | 48 |
Medical management | 32 |
Teaching, research, and continuous education | 28 |
Most of the included articles and questionnaires include more than one category but all 20 included studies or questionnaires contained at least one item or question of the category “communication and patient involvement”. In all, 19 of the studies/questionnaires named a question or item of the category “General interpersonal qualities” and “Medical competence”, while 18 included “Ethics”. Questions or items regarding “Medical management” or “Teaching, research, and continuous education” were found only in half of the studies/questionnaires. The distribution of items/questions is shown in Table 3 .
Occurrence of categories per reference
1 | 2 | 3 | 4 | 5 | 6 | ||
---|---|---|---|---|---|---|---|
General human qualities | Communication and patient involvement | Medical skills and competence | Ethics | Medical management | Teaching, research, and continuous education | ||
Reference | |||||||
1 | General Medical Council (Self) [ ] | X | X | X | X | X | X |
1 | General Medical Council (Patient) | X | X | X | X | – | – |
1 | General Medical Council (Coll) | – | X | X | X | X | X |
1 | Oxford private medical practice | X | X | X | X | – | – |
1998 | Fones CSL, Kua EH, Goh LG [ ] | X | X | X | X | X | X |
1999 | Klingenberg A, Bahrs O, Szecsenyi J [ ] | X | X | X | X | – | – |
2002 | Leahy W, Cullen W, Bury W [ ] | X | X | X | X | – | – |
2004 | Mercer SW [ ] | X | X | – | X | – | – |
2004 | Schattner A, Rudin D, Jellin N [ ] | X | X | X | X | – | X |
2006 | Herzig S [ ] | X | X | X | X | – | X |
2007 | Maudsley G, Williams EM, Taylor DCM [ ] | X | X | X | X | X | X |
2009 | Gilles RA, Warren PR, Messias E, Salazar WH, Wagner PJ, Huff TA [ ] | X | X | X | X | X | – |
2010 | Lambe P, Bristow D [ ] | X | X | X | X | X | X |
2011 | Pfeiffer A, Noden BH, Walker ZA, Aarts R, Ferro J [ ] | X | X | X | X | X | – |
2011 | Kliems. H, Witt CM [ ] | X | X | X | – | – | – |
2014 | Iliescu, L, Carauleanu, A [ ] | X | X | X | X | X | X |
2014 | Miratashi Yazdi SN, Saharnaz N, Arbabi M, Majdzadeh R [ ] | X | X | X | X | X | – |
2014 | Cuesta-Briand B, Auret K, Johnson P, Playford D [ ] | X | X | X | X | X | X |
2015 | Kim JH, Tor PC, King J, Seo JS [ ] | X | X | X | X | X | X |
2016 | Bardgett RJM, Darling JC, Webster E, Kime N [ ] | X | X | X | – | – | – |
Being a practicing doctor is a profession that requires intensive interpersonal contact. For patients the contact with doctors is often a negative experience since it is often connected to pain, illness and uncertainty. This could be one of the reasons why people have high expectations in the interpersonal skills of their doctors.
The category “general interpersonal qualities” contains personal attributes and behaviour, which are not connected to medicine directly. This includes being friendly and nice, polite and cheerful. Making patients feel at ease, showing empathy and being able remain calm under pressure. This category also contains having a positive outlook on life, a good sense of humour, a well-balanced temper and love for people. These are all attributes we would wish to find in all people surrounding us, but especially in doctors.
In an area where people with different backgrounds should decide together in often burdensome and stressful situations, communication is a task of enormous importance. Doctors have to listen carefully to the needs of their patients and share information in an appropriate way, tailored to the abilities of their patients, to reach satisfying outcomes.
The main topics in this category are attentive listening and clear and understandable explaining. This includes explaining tests and test results as well as answering questions honestly, open and in a language the patient can understand. Common rules of polite conversation, like giving enough time to speak about patient history and symptoms without interruptions belong to this category. The involvement of patients in medical decisions is only possible and useful if all necessary information is presented in an understandable way.
This is the core competence of practicing doctors and the most extensive part of medical education is dedicated to the area of medical competences. Medical expertise, manual medical skills in treatment of patients, healing of illnesses and soothing discomfort and pain are included in this category. Examples include the following: taking a good history, find the suitable diagnosis and therapy, accuracy, experience as well as a holistic view on medical problems.
The doctor–patient relationship needs trust and honesty. This could be one of the reasons why people have high expectations about ethics and moral of their doctors. This category contains humbleness, honesty, integrity, trustworthiness and confidentiality as well as motivation and passion for work beyond obligation or financial interests. The ability to be self-reflective and the recognition of one’s own limitations are also part of this concept. Finally ethics include respect for different ethnicities and consideration of different religious and cultural believes.
Doctors, mainly in hospitals but in private practice too, have a list of duties beyond taking care of patients. Doctors take responsibility in leading teams, they represent the hospital and to some extent they represent the whole health system. To fulfill all these responsibilities, they need a set of characteristics that includes intelligence, flexible and independent thinking, decisiveness, good organisational skills and leadership qualities. They should be able to work well in a team and show respect for their colleagues, for students and (medical) staff members. A pleasant appearance and good personal hygiene are part of this category too.
Medicine as a field of science, where research and teaching are part of every day’s life, was mentioned least often in the included articles/questionnaires. Yet this is—without any question—an important part of medical profession. This category included research, teaching and supervision of students and colleagues as well as approachability for young colleagues and a commitment to a lifelong learning process.
As far as we could derive from all included articles/questionnaires, there are different views on the importance of the attributes of good doctors in the different stakeholder groups.
We included 48 items out of patient questionnaires; 24 of these items were matched to the category “communication and patient involvement”, “general interpersonal qualities” was mentioned 8 times as was “medical competence” (n = 8). Items concerning ethical aspects were named 7 times and only once was “medical management” mentioned. Communicative competences are therefore clearly in focus of patient satisfaction questionnaires.
Studies which targeted students’ opinions showed that in only one of the included 4 studies “competence in teaching” (being a good teacher) was rated under the top 5 attributes of a good doctor. The focus of medical students is on “medical competence” and “general interpersonal qualities”. Even for the students, who are directly affected by teaching skills, “medical competence” is rated higher.
Questionnaires and studies with focus on doctors’ opinions rated “medical competence” and “ethics” most important. “General interpersonal qualities” and “communication and patient involvement” are much less valued. In none of the included studies was communication rated as the most important attribute of a good doctor.
Only one article had nurses as a target population. There is not enough data for useful interpretation.
The classification of all attributes in the six categories: (1) General interpersonal qualities, (2) Communication and patient involvement, (3) Medical competence, (4) Ethics, (5) Medical management, (6) Teaching, research, and continuous education appeared conclusive and practical useful. It would also be possible to find other clusters or different labels for similar categories. For several items it was difficult to find only one suitable category. For example, patience in a conversation could be categorised as a communicative quality, but in context of physical examination it could be as a medical skill. Without any further information, patience is a virtue, desirable for all people and therefore it was categorised as a general interpersonal quality. The categories stated here are a useful tool to summarize the gathered information and build a useful framework. In this sense it was possible to find six basic attributes or cluster of attributes in the content of all used studies and questionnaires. For future research on the concept of “good doctor”, it could be useful to consider all 6 areas of interest. On this basis a questionnaire could be developed investigating the concept of “a good doctor” in the Austrian population. In adapted forms it could also be used in other stakeholder groups such as medical students, nurses and other medical professionals to gain a holistic view on this concept.
The different stakeholders showed different preferences in categories. This could be a reason for dissatisfaction and misunderstandings between patients, doctors and students in everyday hospital work. The category “communication and patient involvement” shows this very clearly.
In all the questionnaires used to measure patient satisfaction, communication was a main topic. Whenever people had the chance to rate attributes at their own discretion, it was rated in almost all cases under the top 5 attributes too [ 5 , 7 , 13 , 18 ]. General interpersonal qualities are also highly demanded [ 5 , 7 , 12 , 13 , 18 , 19 ].
For medical education this could be a strong sign towards communication training because communication seems to be a key aspect of patient satisfaction. How medical procedures, therapies and test results are explained, how long a patient has time to talk about his or her medical issues, or how a doctor reacts to questions, is part of good communication. It should not be left to chance if and how this core element of doctor–patient relationship works out. Fallowfield et al. [ 20 ] underline the importance of communication quality in their study on oncologists and their patients. They show that due to a three-day communication training they could improve the quality of questions significantly, reduce the rate of leading questions, and raise empathic behaviour and appropriate reactions.
A very important aspect is communication between doctors and nurses (and other medical professionals). If there are fewer misunderstandings between those two groups, patient care is more effective [ 21 ]. The best way to reach this goal of respectful teamwork and fluent communication is to introduce interprofessional education programmes. Until then, Curtis et al. [ 21 ] suggest special training for structured doctor–nurse communication.
Since 2001, trainings for shared decision making are promoted by the German state. Doctors should learn to ask patients for their tendencies towards participating in medical decisions and how patients can be included in decision making regarding to their abilities and needs [ 22 ].
Many universities have communication training implemented in their curriculum. These lessons are often conducted in a role play setting with simulated patients. Simulated patients or standardized patients are professional or lay actors who exercise different conversations on various topics together with the students. 1 It is also possible to include general interpersonal qualities in a curriculum. An adequately friendly welcome, keeping eye contact, or showing empathy through addressing perceived emotions are skills which can be taught and learned during trainings or in practical education.
In the curriculum of the Medical University of Vienna the mandatory element “soziale Kompetenz” (social competence) is implemented. Intended learning outcomes of this training are adequate communication, empathy, appreciation and professional behaviour in an interdisciplinary team. The students have the chance to learn those social competences in contact with people in need of care in a nursing home.
A very important aspect remained unaddressed: Asking patients about their own beliefs and concepts of sickness, health and the origin of their disease as well as asking about complementary medicine and “self-treatment”. This whole area was not covered in the included literature, despite there being strong evidence that this can be an important part of recovery [ 23 , 24 ].
Doctors themselves emphasise medical competence as their most important attribute. This is without question an area of great impact and a core competence. Patients do not rank this category as high as doctors—maybe because patients as lay persons do not have the skills to evaluate the quality of their doctor’s work in the sense of medical competence and therefore just assume that every doctor is qualified and reliable.
Nurses and other medical professionals could contribute important insights in the everyday work of doctors and the day-to-day experience of patients. This could be of greatest interest for the definition of what makes a good doctor.
To assess the real differences between all stakeholder groups, it is necessary to collect data on representative samples with standardised and similar methods. This study can provide the theoretical groundwork.
Open access funding provided by Medical University of Vienna.
V. Steiner-Hofbauer, B. Schrank, and A. Holzinger declare that they have no competing interests.
1 The simulated patient programmes of the Charité in Berlin ( https://lernzentrum.charite.de/ressourcen/simulationspatienten/ ) and the Medical University of Vienna ( https://teachingcenter.meduniwien.ac.at/abteilungen/methodik-und-entwicklung/schauspielpatientinnen-programm/ ) serve as examples for many other similar programmes.
Medical School Expert
Every article is fact-checked by a medical professional. However, inaccuracies may still persist.
Being a good doctor takes the perfect mix of personal qualities, characteristics and attitudes, that all go into providing excellent care to patients.
Every doctor is an individual, so will approach medicine from a slightly different angle, but there are some qualities and attributes that crop up time and time again when investigating what makes great doctors good.
The top 13 qualities of a good doctor are:
Having worked as a doctor for a few years now, I’ve come across my fair share of excellent doctors, as well as a very small handful who lacked a couple of the key qualities above.
In this article, I’m going to explore each of the above qualities of a good doctor, look at how they relate to everyday clinical practice, and explore how you could demonstrate them if you were applying to medical school.
INCLUDED IN THIS GUIDE:
Every new patient you see in clinical practice is essentially a new problem to be solved.
You’re given bits of information from lots of different sources: what the patient is telling you, what you can feel when examining the patient, the results of any blood tests or scans you’ve performed…
It’s then your job as a doctor to put all these snippets together to solve the problem of the patient’s diagnosis.
Now, don’t get me wrong, sometime it’s a very easy problem to solve.
If a patient is presenting with a sore throat, cough and runny nose, they probably have a cold.
But, there are other times when you just pick up one sign that’s slightly off, such as a blood test that comes back just slightly above the normal range, that then leads you down a rabbit hole of diagnosing an otherwise symptomless disease.
Good doctors are almost always excellent problem solvers- whether or not they actually realise it themselves!
In reality, most of modern medicine isn’t wild left-field diagnoses in the style of Dr House.
The majority of your day-to-day work as a doctor hinges on following protocols with attention to detail.
This lets you pick up on anything the patient says that stands out as abnormal or any test results that return outside of the expected ranges.
A very simple test that doctors can perform is a urine dip test.
This test can detect microscopic amounts of blood in a person’s urine.
There are many different reasons for blood being found in a patient’s urine, such as if she’s on her period, but there’s always an outside chance that it can signal something far more serious (such as kidney cancer).
A doctor who’s not conscientious could easily put a positive result down to one of these many harmless reasons and not bother repeating the test.
But, a conscientious doctor would always take a second look at something that’s not expected and so may find something nasty far, far sooner.
You can be the most technically brilliant doctor in the world, but if you can’t communicate your plan to the patient, they’re not going to follow your treatment regime and they’re not going to get any better.
It was only once I began work as a doctor that I truly started to gain an appreciation for just how important communication skills are.
Now, it had been drilled into us at medical school, the importance of good communication and how to converse clearly with patients, but it’s only once you start regularly interacting with the general public that you get a sense of what level you need to pitch your explanations at.
(Learn how to tackle the MMI communication station here. )
As a doctor, you’ve spent five years at medical school learning almost a whole other language of medical jargon and terms.
And with that background of knowledge, it’s just far too easy to forget what you didn’t know before going through the whole process.
I remember before medical school, I wouldn’t have been able to tell you where the liver sat in the body.
Despite this, without thinking as a doctor, I could very easily launch into an explanation to a patient about their liver and what was wrong with it, completely forgetting that they may not even know what a liver really is!
Communication skills are vital for a doctor to be able to make themselves understood and keep the patient onside when it comes to their treatment regime.
I can’t say I’ve ever been an amazingly organised person.
However, I can say that working as a junior doctor has genuinely greatly improved my personal organisation skills.
As a busy doctor on the wards or in a GP practice, you’ve got to keep track of a hundred different tasks and duties, all of varying importance and urgency.
The stakes are high because losing track of an important job you need to do could directly negatively impact the quality of care for a patient.
If a patient needs an urgent x-ray, and you forget to book it because you got distracted, it’s not going to look good for you.
Personal organisation is what will let you keep track of everything you need to do, prioritising the most urgent tasks to the top of your to-do list.
This will mean you get the important stuff done even if you’re being bombarded on all sides by nurses, patients or other doctors asking for things.
Out of this entire list, I’ve got to say I think honesty is one of the most important qualities for a doctor to have.
You just can’t have a dishonest doctor.
Doctors have easy access to controlled drugs, private patient information and can make life-changing decisions for the person sat in front of them.
A good doctor would never prescribe a medication just because they’d get a kickback from the pharmaceutical company who sold it, they’d never steal controlled drugs to sell them, and they’d never look at a patient’s private medical record unless they needed to.
Honesty is such an important quality for a doctor to have that even minor breaches are often cause for a fitness to practice meeting with the GMC.
For example, if a doctor were to do something as relatively minor as lie to get out of a parking ticket, and this fact came to light, they’d very likely face professional repercussions due to the fact that this act called their professional integrity into question.
Once you start work in healthcare, you very quickly learn that it is very much a team sport.
As much as TV shows or movies make out, the doctor is not the be-all and end-all of patient care.
A huge team works both clinically and behind the scenes to care for patients- both in and out of hospitals.
You’ve got doctors, nurses, pharmacists, physiotherapists, occupational therapists, healthcare assistants, ward clerks, cleaners, phlebotomists and dieticians to name just a few of the professions that might be involved in delivering care to a patient.
To be a good doctor, you need to be able to act as a specialised cog in this larger healthcare machine, working closely and effectively with your colleagues.
Even between doctors, teamwork is essential to delivering high-quality care.
Doctors work with other doctors to ask for specialist opinions, doctors perform operations together and doctors help each other out on busy days on the ward.
If you can’t work collaboratively, then you’re just not going to be a productive member of the team- and so hinder the delivery of care to your patients.
You very likely reflect on things without even knowing it.
Reflection is essentially just thinking about something that happened, thinking about why it happened and how you responded, and thinking about what you could do better next time.
In medicine, this process is central to becoming a better doctor.
Reflection is one of the best ways to learn from your experiences and implement positive change in your future practice.
As a doctor, this activity of reflecting is actually formalised into a written exercise.
In order to revalidate as a doctor every year, I have to produce a set number of written reflections detailing events I’ve experienced and what I learnt from them.
Although it may sound easy enough, there’s undoubtedly a bit of knack to getting good at reflecting.
I’d go so far as to say it’s actually a skill you’ll develop over a lifetime, but having the innate quality of being able to look back over your past actions and draw learning points out will definitely contribute to being a good doctor.
What makes practising medicine different from killing cancer cells in a laboratory, is that you’ve got a person, not a petri dish, at the receiving end of your actions.
In the often confusing and scary environments of A&E departments, operating theatres or intensive care units, a doctor can act as a point of contact to describe and explain exactly what’s happening (and what’s going to happen) to a patient.
It’s easy to forget how overwhelming healthcare settings can be, especially when you work there every day, but a strong sense of empathy will allow a doctor to appreciate how their patients may be feeling and so let them work to reassure them.
Empathy is integral to the patient experience.
Something as simple as fetching a cup of tea and a sandwich for a patient who’s been sat in A&E for 4 hours can turn their terrible evening into a slightly less terrible one.
From breaking bad news to commiserating family members, the quality of empathy is unquestionably vital to being a good doctor.
Resilience isn’t necessarily something you’d immediately associate with being a good doctor.
However, I can assure you it’s just as important a quality as any other on this list.
The reality is, the road to both becoming a doctor, and working as one, can be a bit of a long old slog.
You’ve first got the years at medical school, with make-or-break exams around every corner, then comes the somewhat relentless feeling years as a junior doctor, working long hours for relatively little pay.
Finally, after approximately 10 years in the game, you can exit the training pipeline and take up a post as a consultant.
Sometimes, you’ve got to be resilient to keep on pushing.
That could be continuing to sort out jobs long after your shift officially finished, that could be maintaining concentration in an operation that’s taking much longer than expected, or that could be meeting your next patient with a friendly smile after the last one was openly rude about you and your team.
Without resilience, a doctor is far more likely to burn out and so stop being able to deliver good care to patients.
Respect isn’t just about being polite to your patients and colleagues.
Respect is also about taking anything a patient or colleague tells you seriously and acting upon it if required.
This could be a patient telling you that they received a substandard quality of care.
Instead of just brushing them off as a troublemaker, a doctor who truly respects their patients would explore this report to find out if anything could be improved for next time.
That being said, the core quality of respect does include a requirement to treat people professionally.
Shouting at a nurse because she forgot to give a patient a medication you prescribed isn’t respecting her as an individual.
Ignoring requests for advice from other doctors isn’t showing them respect as clinical equals.
The quality of respect is embedded in everything a good doctor does, from dealing with angry patients to teaching medical students.
A good doctor is always willing to take responsibility for their actions.
No matter how serious the consequences may be.
The NHS has actually formalised this requirement to take responsibility into the ‘duty of candour.’
What this essentially means is that anytime harm does, or could have, come to a patient the healthcare professional involved has to tell them about it.
I had my first experience of fulfilling my duty of candour about a week into my first job as a junior doctor.
One of my colleagues had asked me to help them out with a few small jobs, one of which was to take some blood from a patient.
Only taking down the patient’s bed space, I went to that bed on the ward and duly took blood from the patient lying there.
What I didn’t know, was that the patient my colleague had wanted me to bleed had just moved spots on the ward.
I’d taken blood from the wrong patient so immediately went to the patient I’d bled to explain the situation and apologise.
Thankfully, they really didn’t mind that I’d made the mistake but the same requirement for candour holds true even if I’d performed an operation on the wrong patient.
Academic ability is a quality required by doctors throughout their training.
There’s just no getting around the fact that to be a good doctor you have to learn and memorise a vast quantity of medical information.
Different types of drugs, their side effects, different diseases and their symptoms… Although as a doctor you can always look information up, you’re able to work much quicker and more efficiently if you have key facts memorised.
A second reason that to be a good doctor you have to be good academically is because of the sheer number of exams you have to take!
Unfortunately, exams don’t finish even once you’ve graduated from medical school.
Every medical specialty, whether that be anaesthetics, rheumatology or general practice, has its own specialist exams that doctors training in that field have to take.
Most people have excellent academic ability just by virtue of having been able to get into medical school, but it is certainly a quality that continues to be relevant throughout a doctor’s career.
Finally, I think this last quality of a good doctor may be the most underrated on the list.
As a doctor, nine times out of ten you won’t be dealing with a complete information set.
Diseases very rarely present exactly as they’re described in the textbooks, so there’s always a bit of uncertainty regarding which symptoms a patient is describing could be down to a particular condition.
Every test we do in medicine has both false positive rates and false negative rates, so we can never be truly sure that a test has come back to us 100% accurate.
Often times the investigation that would give us a definite answer just can’t be done for every patient we see. For example, it would be far too expensive for the NHS to MRI every elderly person with knee pain when the vast majority could be diagnosed with arthritis without the need for a scan.
Doctors have to be masters of treating the ‘most likely’ scenario, whilst always bearing in mind the ‘most serious’ diagnosis that could be underlying a patient’s presentation.
GPs are arguably the experts at dealing with this uncertainty due to the fact they have far fewer tests at their fingertips compared to their hospital colleagues. However, every good doctor will manage it to some extent.
If you are in the process of applying to medicine, you may have recognised some of these qualities of a good doctor.
That’s because I selected the 13 most relevant qualities from the Medical Schools Council’s ‘Statement On The Core Values And Attributes Needed To Study Medicine.’
It shouldn’t come as a surprise that many of the attributes needed to study medicine also feed into a doctor being good at their job.
Everyone will have their own slightly different definitions of what the qualities of a good doctor are, but I thought these 13 were as good as any and could easily see how each applied to my working life.
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© 2024 Medical School Expert Ltd
Choosing the right doctor can be a daunting task, but it’s essential to ensure you receive the best possible care. In this article, we’ll explore 20 essential qualities that make a good doctor, so you can feel confident in your choice.
A good doctor must have a deep understanding of the human body and stay up-to-date with the latest medical advancements and treatments. Patients want to know that their doctor has the knowledge and expertise to diagnose and treat their health problems with confidence. This is an essential aspect of one of the 20 qualities that make a good doctor
Good communication is key for a good doctor. Patients must feel comfortable talking to their doctor about their health problems and concerns, and a physician who listens attentively and explains medical conditions in an easy-to-understand way is highly valued. Effective communication also helps to build trust between the doctor and patient, which is essential for a positive doctor-patient relationship.
When patients visit the doctor, they often feel vulnerable and in pain. A doctor who shows compassion and empathy, putting themselves in the patient’s shoes and understanding their needs and concerns, can help patients feel more comfortable and at ease. Patients need this as an important factor that determines one of the 20 qualities that make a good doctor.
Patients appreciate doctors who are available and accessible when they need them. A doctor who is always there to answer questions and provide support can reduce the stress and anxiety that patients often experience when dealing with health problems. Patients should have easy access to their doctor, either through appointments or telemedicine services.
A good doctor must pay close attention to detail. They must thoroughly examine and assess patients and be able to identify even the smallest symptoms and signs. This helps ensure that patients receive an accurate diagnosis and the right treatment plan for their specific needs. This also is an essential part of the 20 qualities that make a good doctor
Patients trust that their doctor will act in their best interests and uphold strong ethical standards. Doctors must be committed to ethical principles and providing the highest standard of care to their patients.
A good doctor must have strong problem-solving skills and be able to quickly and effectively diagnose and treat health problems. They must think critically and find creative solutions to complex medical issues.
The medical field is constantly evolving, and it is essential that doctors stay up-to-date with the latest advancements and incorporate new technologies and treatments into their practice. A good doctor must be willing to continuously learn and improve.
Healthcare can be fast-paced and stressful, and it is essential that doctors can work well under pressure. They must remain calm and composed in high-stress situations and make quick and effective decisions.
A good doctor must have good time management skills and effectively manage their schedule and prioritize their tasks. This helps ensure that they can provide the best possible care to their patients and meet their needs in a timely manner.
A doctor’s ability to build strong relationships with patients is crucial. Patients want to feel that their doctor cares about them and their health , and a doctor who can build strong, trusting relationships with their patients is more likely to provide high-quality care and achieve positive outcomes.
A good doctor must have active listening skills and listen attentively to their patients. They must take the time to understand their patients’ concerns and needs and provide personalized care tailored to their needs.
Patients want to trust that their doctor will respect their privacy and confidentiality. Doctors must be committed to maintaining the privacy and confidentiality of their patients and always act in accordance with ethical and legal standards.
Healthcare is a collaborative industry, and it is essential that doctors can work effectively as part of a team. They must communicate well with other healthcare professionals, including nurses, specialists, and support staff, and be committed to working together to provide the best possible care to their patients.
A good doctor must have a positive attitude and behave professionally with patients and other healthcare professionals. They must be respectful and courteous and provide the highest standard of care to their patients.
Patient safety must always be a top priority for doctors. They must follow established protocols and procedures to ensure the safety and well-being of their patients.
A good doctor must be willing to go the extra mile to provide the best possible care to their patients. They must provide personalized, high-quality care and be willing to do whatever it takes to meet the needs of their patients.
The healthcare industry is constantly changing, and it is essential that doctors can adapt to new technologies and treatments. A good doctor must be flexible and quickly adapt to changes in the industry, incorporating new advancements into their practice.
A good doctor must respect diversity and inclusion and provide care to patients from all backgrounds and cultures. They must be culturally sensitive and provide care tailored to the specific needs and beliefs of their patients.
Finally, a good doctor must have a passion for helping others. They must be motivated by a desire to make a positive impact on the lives of their patients and be committed to providing the best possible care to those in need.
In conclusion, a good doctor must have knowledge and expertise, good communication skills, show compassion and empathy, be available and accessible, pay close attention to detail, have strong ethical standards, good problem-solving skills, and a willingness to continuously learn and improve, among other qualities. By considering these factors, you can be confident that you are receiving the best possible care and treatment for your health problems. The healthcare industry is critical, and it’s essential that you have access to high-quality care from doctors who are committed to providing the best possible care.
You deserve the best possible care, and it’s essential to choose a doctor who is right for you. By considering these 20 qualities, you can make informed decisions about your healthcare and have access to high-quality medical professionals who are dedicated to providing the best possible care.
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Home » Application Guide » What Are The Qualities Of A Good Doctor?
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Medicine is a vocational course that demands resilient professionalism under a core set of values that is imperative in our care of the most fragile in our society. If you can’t demonstrate that you understand what it means to be a good doctor, your academic achievements won’t be enough to get you into Medical School and excel in your future careers.
So what are the skills and qualities of a good doctor?
One of the best ways to define the skills and qualities that makes a good doctor is from hearing what the experts in the field say. These are the people that have seen the good and bad qualities of doctors, and the impact these qualities have on patients and healthcare as a whole.
Sir Peter Rubin (Chair of the General Medical Council from 2009-2014) stated that “Doctors have the enormous privilege of touching and changing lives. Through all the changes driven by research and public expectations, some of the art and science of medicine has endured down the ages and defines medicine as a profession, whatever a doctor’s area of practice.”
He goes on to list some core skills and qualities of doctors, starting with being able to synthesise conflicting and incomplete information to reach a diagnosis. The next is dealing with uncertainty:
“Protocols are great, but doctors often must work off-protocol in the best interests of the patient, for example, when the best treatment for one condition may make a co-existing condition worse.”
“Many patients are alive today because doctors took risks and as doctors, we bring all our professional experience to bear on knowing when acceptable, informed and carefully considered risk ends and recklessness begins – and we share that information openly and honestly with our patients, always respecting that the final decision is theirs.”
“Ensuring that those standards, which are immutable, are preserved while those that are simply a product of their time are consigned to history carry and accept ultimate responsibility for our actions.”
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Sir Peter Rubin finishes by saying “Those of us who practise and teach medicine now are merely the custodians of those core values which were passed on to us by earlier generations and which we, in turn, will pass on to those who come after us. It is these values and these qualities which define a good doctor: they are timeless and long may they remain so.”
Focussing on the qualities and skills more specifically, here are further attributes that are described as the fundamentals of being a good doctor.
As Dr. John Madden of St. George’s University mentions, “Being a good listener is critical to being a good doctor.” Effective communication with patients is key to understanding patients’ issues and concerns but also to explain a diagnosis to them. When explaining a diagnosis, good communication skills are highlighted by taking into account a patient’s medical knowledge so they understand exactly what the situation is, however difficult it may be for them, such as when a diagnosis is terminal.
Regarding communication skills, the GMC say that Doctors must be able to:
Having good communication skills opens many doors. You will be an excellent person to include in any team and a hit once you start talking to patients. Communication skills are not solely for medical school interviews and the medical school itself; they are vital throughout a doctor’s entire career. They will really define you as a doctor.
We break down communication skills in much more detail in our guide here and explain how you can improve and demonstrate these skills during interviews.
Doctors must maintain professionalism at all times. As a doctor, you have a duty to treat all patients with respect and display appropriate emotional maturity across interactions. Doing this will also help patients feel more comfortable and trust you with their health. It’s important to note that it doesn’t just end with patients, it is also your responsibility to ensure that your colleagues provide nothing but the best patient support they can.
There are, of course, many more qualities that we have not explored in detail such as emotional intelligence, leadership skills, attention to detail, teamwork skills, strong work ethic and curiosity. If you are still craving further details, check out the GMC website.
Throughout your time in medical school and during the first few years after you graduate, you will pick up an unfathomable amount of skills that will help you to become a good doctor. The good news is that you don’t have to wait until you start further education to begin developing these skills. In fact, you likely already have some of them, which makes it crucial to discuss these in your personal statement and interviews.
The Medical Schools Council (MSC) has a list of qualities that you should be able to demonstrate to medical schools.
How many of these qualities can you tick off, and more importantly, do you have evidence of times you demonstrated them?
This is what Oxford University say are the personal characteristics they look for in applicants applying to their Medicine Degree.
Similar to the MSC list, do you have the skills listed by Oxford? If by some bizarre coincidence, everyone reading this is applying to Oxford, then you can just use what Oxford say above. However, if you’re not applying to Oxford, most med schools tend to explain the key qualities they look for/expect of their students. Make sure you check the websites of the med schools you are applying to.
We have plenty of free guides available at 6med to help you understand these qualities better, including resilience , empathy and ethics . If you are looking to demonstrate these qualities effectively, our Medicine Mastery Bundle helps you to explain the qualities in your Personal Statement and during your Interviews, as well as help you get a high score on the UCAT.
Your aim at interview is to try to get the Admissions Tutors to tick off the qualities we mentioned earlier. This means you should focus on personal experiences that demonstrate the qualities of a good doctor.
We cover this more in our guide on how to demonstrate the key qualities of a doctor , but here are a few ideas:
If you feel weaker in some areas, for example, you don’t think you’re decisive enough – that’s completely fine, but make sure you know how you’re going to work on these weak areas and show the medical school you’re trying to improve.
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You may be asked the exact question “what makes a good doctor?”, but it is more common that you’ll be asked a question related to this and your motivation for becoming a doctor. Here are some examples of the questions with some answers:
Why did you choose Medicine?
The classic medicine interview question – you definitely want to specifically prepare this one and use it as a framework for other ones.
There are many ways to answer this. In this example, we state a reason, explain it then support it with evidence. You can alternatively, for instance, base your whole answer around an experience, or multiple experiences.
Start with a direct answer to the question listing main points.
I like medicine because it connects science and art.
Explain your two points.
Medicine is a science – as a doctor, you use medicine to manipulate the body to respond effectively to disease. This requires knowledge and understanding of the way our body has evolved to work. Application of this knowledge (based on understanding) is necessary to make informed clinical decisions.
Art – there aren’t always clear rules dictating how best to treat a patient. A doctor needs to weigh pros/cons of treatments, treat patients with empathy, approach ethical dilemmas.
Medicine allows me to directly help people and make a positive difference while being challenged/mentally stimulated.
Medicine is a unique career that cannot be pursued based on anecdotal evidence or through reading the description of the job alone. Hence why I arranged work experience to find out more about the career .
Giving supporting evidence of being proactive. Evidence and experience are what makes your question more personal.
Be sure to use the STARR technique when citing experience.
The job doesn’t only involve treating patients. It involves constant learning, teaching colleagues, supporting colleagues. [expand…]
This shows a good understanding of the career and the qualities of a good doctor.
What aspects of being a doctor DON'T appeal to you?
The key is to maintain a balanced view. You should be aware of the flaws while not making the profession seem all doom and gloom – justifying why it’s a fit for you. Maintain positivity without belittling these problems. Here are some drawbacks to being a doctor along with counter-arguments, they further show your understanding of the qualities of a good doctor:
The job can be very stressful as being a doctor is such a great responsibility – stress can affect personal life, the time-commitment can also affect personal life
Counter: It’s important to find a good work-life balance. A good coping mechanism could be not compromising hobbies / extra-curricular.
You could mention how you are dealing with this currently – what extracurricular activities do you do?
Being too attached to patients – the burden of their life can be difficult to bear. Dealing with death can be hard.
Counter: It’s important to talk to people and not bottle up feelings. Thankfully, there is plenty of support available for doctors.
Refer to the specific support available to doctors. You could mention an example of an occasion where you spoke out or helped someone else with problems they had.
You could potentially get a question on your weaknesses – we recommend you try to avoid giving an answer that’s considered a key quality in a doctor.
It is clear, from these questions, that having a solid understanding of the qualities of a good doctor is crucial for formulating the answers that tick the Admissions Tutors’ boxes. Aside from meeting the preferred characteristics that medical schools are looking for, developing the key qualities early will set you up for the careers ahead of you. Take your time now, before the application deadline and interview season, to work through the key qualities, see how you meet them and prepare examples of times you demonstrated them.
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The medical profession is a noble and challenging one, with countless aspiring doctors dreaming of one day donning the white coat and stethoscope. But what separates a good doctor from a great one? What are the qualities that make a physician truly excel in their field? This article will unveil the secret ingredients that make a top-tier doctor and provide insights on how to cultivate these traits in your own journey towards becoming a medical professional.
The foundation of any good doctor-patient relationship is effective communication. A great doctor is able to listen attentively to their patient's concerns, ask the right questions, and explain complex medical information in an understandable way. This not only helps patients feel more at ease, but it also aids in accurate diagnosis and treatment planning.
A good doctor must possess a solid foundation of medical knowledge and stay up-to-date with the latest advancements in their field. This ensures that they can provide the best possible care to their patients, utilizing the most current diagnostic tools, treatments, and protocols.
The ability to think critically and solve problems is crucial for a doctor. They must be able to sift through a myriad of symptoms and medical history to arrive at an accurate diagnosis and determine the best course of treatment.
One of the most important qualities of a good doctor is their ability to empathize with patients and show genuine compassion for their well-being. This helps to build trust, put patients at ease, and ensure that they feel supported throughout their healthcare journey.
The field of medicine is constantly evolving, with new discoveries, technologies, and challenges arising every day. A good doctor must be adaptable and resilient, able to navigate the ever-changing landscape of healthcare while maintaining their commitment to providing excellent patient care.
A great doctor consistently upholds high standards of professionalism and ethical integrity in all aspects of their work. This includes maintaining patient confidentiality, advocating for patients' best interests, and adhering to the principles of evidence-based medicine.
Effective collaboration with other healthcare professionals is essential for a good doctor. They must be able to work seamlessly with nurses, specialists, and other team members to ensure that patients receive well-coordinated, comprehensive care.
The journey to becoming a good doctor is one of continuous learning, growth, and self-improvement. By cultivating these essential qualities, you can not only excel in your chosen field but also make a lasting, positive impact on the lives of your patients. Remember that the pursuit of excellence in medicine is not just about acquiring clinical skills and knowledge; it also involves nurturing empathy, resilience, and ethical integrity. So, keep striving to be the best doctor you can be, and watch as your career and patient relationships flourish.
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“The more we care for the happiness of others, the greater our own sense of well being becomes.” The Medicine of Altruism: Dalai Lama
Introduction
The fundamental mission of any medical school is to select those individuals who possess the qualities and personality traits best suited to becoming a good doctor. The first part of this article takes a critical look at how United Kingdom (UK) medical schools select doctors, which can vary considerably, and asks whether it can be improved. The qualities needed to be a good doctor are discussed and asks whether work experience illustrates at least some of these personal qualities and should therefore be an essential prerequisite for applying to medical school. Such experience helps the student to make an informed career choice and exploring it at interview can reflect student motivation to study medicine. My experience in Ghana gave me the opportunity to find out at first hand if I had what it takes to become a doctor. The trip was totally inspirational. It made me realise that medicine is much more than being master of all sciences. In Ghana I saw many of the qualities one needs to be a doctor, how this contrasts with the current selection criteria in the UK, and made me wonder whether the UK system offers our society the best practice available.
Critique of UK medical school selection
Applying to medical school has become increasingly competitive. Selection into medical schools is not an exact science but one assumes that best available evidence is being used. The present system almost certainly turns away students who would make good doctors and accepts some who are mediocre or poor or even drop out of medicine altogether. The selection criteria for entry into medicine have to be accurate. However, no system is fool proof and the number of drop-outs in UK training stands at 6.8 – 12%. 1,2,3 I believe that better selection criteria would reduce the drop-out rate and save personal distress among those who made an unwise choice. This makes economic sense. There is widespread agreement that we should select medical students on wider criteria than scores of academic success, 4, 5 though in practice many medical schools have valued academic scores at the expense of other considerations. 6, 7 A Levels alone should not be sufficient to gain a place at medical school. True communication calls for some shared life experiences and empathy with others. I believe that students who are totally absorbed in their studies to the exclusion of almost everything else are less likely to make good doctors. In one study, a ten-year follow-up after entry into medical school showed no correlation between academic score at entry and drop-out rate, but significant correlation between low interview scores and later drop-out. 8 Reasons for drop-out were a variety of personal reasons including lack of motivation for study or for medicine. In a medical school that carefully evaluates applicants, empathy and motivation to be doctors were found to be particularly important in predicting both clinical and academic success. 9
Another major study, looking at the dropping out from medical schools in the UK over a ten year period (1990-2000), 10 showed that drop-out rates increased during this period and concluded that the probability of dropping out of medical school is 20% lower for students with a parent who is a doctor. The authors comment that this may be the result of greater commitment or better preparation and insight before starting the course. Ethnic background of students was recorded only between 1998-2000. The study found that Indian females were around 1.9% less likely to drop out compared with white females, whereas Indian males were no different from white males. Other ethnic groups were less likely to drop-out by around 0.8%. A concerning fact in this paper was the degree to which drop-out rates varied between different medical schools. No study to date has been done to find the reasons for these differences. Surely potential applicants need to be aware of these results. The differences could be accounted for by variable selection processes among the medical schools. 11 Some medical schools shortlist for interview only on predicted academic performance or the number of A* GCSEs or decide by the UK Clinical Aptitude Test (UKCAT) / BioMedical Admissions Test (BMAT) scores. Some use information presented in the candidate’s personal statement and referee’s report while others ignore this because of concern over bias. In some cases candidates fill in a supplementary questionnaire. Interviews vary in terms of length, panel composition, structure, content, and scoring methods. Some schools do not interview.
The commonest reasons cited in many papers for dropping out of medical school were because it is not for them, they found it boring, they did not like patients, the work environment was not what they want to spend their time on, or they did not like responsibility. 12 Essentially they had realised too late that Medicine was not for them. They had failed to find out what they were letting themselves in for before applying and the medical school had failed to pick this up. There is a strong argument for pooling resources so that applicants get one good assessment instead of four poor ones.
A levels, used for medical selection, do not indicate any personality attributes of the candidate and are affected by socio-economic bias. The UKCAT was introduced to level the playing fields. This test doesn’t examine acquired knowledge and candidates can’t be coached to pass, so in theory it should provide a fairer assessment of aptitude than A level grades. It was also thought that the various components of the UKCAT, namely verbal reasoning, quantitative reasoning, abstract reasoning, and decision making, could help to pick the students who have the personality attributes to make good doctors. Unfortunately, a recent paper suggests that the UKCAT does not provide any more assessment of aptitude than A levels. 13 However, an inherent favourable bias towards students from well-off backgrounds or from grammar and independent schools was also found. Moreover the test does not compensate for talented candidates whose education has been affected by attending a poor school. Another paper looked at the predictive validity of the UKCAT. 14 This showed that UKCAT scores did not predict Year 1 performance at two medical schools. Although early prediction is not the primary aim of the UKCAT, there is some cause for concern that the test failed to show even the small-to-moderate predictive power demonstrated by similar admission tools.
There is no doubt that potential doctors must have enough intellectual capacity to do the job but they must also possess other important traits (Table 1):
Concern for people | Committed to self-learning |
Sense of responsibility | Emotionally stable |
Professionalism | Good judgement and perception |
Good communication skills | Good listener |
Highly motivated | An enquiring mind |
Honesty | Well organised |
Integrity | Patience |
Ability to handle pressure | Mental strength |
Confident | Resilience |
Determination | Respect for other people |
Perseverance | Respect for confidentiality |
Decisiveness | Tolerance |
Conscientious | Hard working |
Team player | An open mind |
Leadership qualities | A rational approach to problems |
Humility | Critical reasoning |
Flexible and adaptable to change | Separate important points from detail |
Logical thinking | Recognise limits of professional competence |
What patients rate highly among the qualities of a good doctor are high levels of empathy and interpersonal skills. 15 Personality traits such as conscientiousness have been positively associated with pre-clinical performance. 16
The criteria being used more and more by admission tutors include the candidate’s insight into medicine including as evidenced from work experience. 17 Surprisingly, very little has been written on work experience and the value placed on it varies considerably between medical schools. Many would regard this experience as a prerequisite for entry into medical school. It enables a student to experience at first hand what he/she is letting him/herself in for. Some find the experience fascinating and challenging while others may find it is not for them. Work experience should not be seen as a hurdle to climb, but part of the decision-making process in determining whether medicine really is for you. I fear that another contributing factor to the increase in drop-out rates from medical schools is the increasing difficulty in obtaining work experience. Gone are the days when students could join theatre staff and watch an exciting operation or shadow doctors in Accident and Emergency (A&E). Useful work experience is so important and it is becoming harder and harder to get, but is still possible. Therefore considerable desire, commitment and motivation by the student are required to obtain it. The work does not need to be medically related, but work experience in any care setting is essential. These placements can be used to illustrate at least some of the personal qualities that are sought after in a good doctor including: appreciation of the communication skills required of a doctor; a thorough awareness of the realities of medicine and the National Health Service (NHS); an understanding of teamwork; an ability to balance commitments; and observation of the caring and compassionate nature of the doctors. Furthermore, as demonstrated in general practice, 18 personal experiences can have a highly positive influence on an individual’s attitude to a particular speciality. Encouraging school students to experience general practice would therefore not only increase their awareness of the life to which they are about to commit, but could aid recruitment to general practice as a speciality.
My Ghana Experience
I decided that, as part of my work experience, I would go to Ghana with a charity organisation (Motec UK Life). The reason was not to impress medical admissions tutors, but to discover if I had what it takes to become a doctor. I realised how comfortably we live in our small bubble, with little appreciation of what goes on in the rest of the world. Ghana is a third world country, which not only has great poverty and malnutrition but also has many deadly diseases such as Acquired Immunodeficiency Syndrome (AIDS)/Human Immunodeficiency Virus (HIV), malaria, hepatitis, typhoid and sickle cell disease. My trip was demanding as I was stripped of my luxuries and removed from my comfort zone, but it helped me to understand the real values in life through helping the most needy and vulnerable people. I felt the suffering and the pain they went through, day in and day out, but knew that making even the slightest difference to their lives motivated me and enabled me to persevere through my time there.
One of the hospitals we stayedwas Nkawkaw, which was in the middle of a shantytown with houses made of metal sheets. Yet, despite the presence of great poverty and disease, I did not find a single person who was not extremely kind and welcoming and always smiling. It made me think of the contrasting situation back home in the UK where people were relatively well off, and yet so unhappy. I spoke to as many people as possible, not realising that I was developing my people- and communication-skills. I played football with the children and made them smile. I was able to visit the AIDS/HIV clinic and gained a first-hand account of how this devastating disease was controlled and dealt with in a third-world country. The pain, grief and suffering were immense and difficult to comprehend unless one was actually there witnessing it. AIDS here hurts everyone, but children are always the most vulnerable. The children were born with HIV from their mothers, or infected through breast milk, or in the past infected by unsafe medical treatments. They were often orphaned and destitute, having to build their own homes, grow their own food, and care for younger brothers and sisters. That is the cruel reality.
Equally heartbreaking was seeing so many people in the HIV clinic who could
not afford the anti-retroviral drug that would improve the quality and duration of life. This feeling of helplessness motivated me even further to pursue a career in medicine in order to help people at their most vulnerable. On this trip I was greatly impressed by the dedication, commitment and professionalism shown by the doctors in difficult situations. I saw doctors working with little supervision and little equipment, and yet they seemed confident, well organised, and adapted themselves well to the conditions. Their enthusiasm and compassion never waned despite working long hours.
I saw many types of operation being performed including joint replacements, hernia repairs and caesarean sections. On one particular day, I observed the team performing many knee and hip joint replacements. The deformities of the joints were much more severe than seen in the UK. I enjoyed and appreciated the skills of the orthopaedic surgeons in carrying out these operations, which were being done under spinal anaesthesia, and so I was able to talk to the patients and comfort them. Throughout the day, after seeing many operations, I did not flinch or feel queasy at the sight, and this further encouraged me to believe that I could handle a career in medicine. On watching the caesarean sections, the excitement of bringing new life into the world was overwhelming. Seeing another baby being born with severe hydrocephalus marred this. No treatment facilities for this condition were available for hundreds of miles and the baby was too ill to be transferred such a large distance. I witnessed the doctors conveying the heartbreaking news to the family with compassion. It became clear to me that there are negative aspects to this career. There is a great deal of emotion and stress to cope with in such circumstances but I believe that, given training, I would be mentally stronger to take control of these situations.
I was always allowed to follow the doctors on their ward rounds, and was encouraged to ask questions and make comments, so that I often felt that I was being treated as a medical student, which was strange in some ways but also very gratifying. On this trip I was involved in teaching and in helping to set up a workshop, which lasted for a whole day for doctors from all over Ghana. This involved lectures as well as demonstrating the latest surgical and theatre equipment. I was impressed by the teamwork and organisation shown by the group. The communication skills of the group had to be of the highest quality in order to get the message across. I found that teaching about the devastating effects of HIV, in a local school in Ghana, was particularly challenging as some of the students before me were sufferers and so I found it difficult to look them in the eye, knowing that although they were being taught the safety precautions, many did not have much of a future. This reinforced my feeling of helplessness but, although this situation was heartbreaking, I remained enthusiastic for the children, to keep their morale high in order to prepare them for their inevitable future.
Conclusion
My trip was totally inspirational. It made me realise that medicine is much more than being a master of all sciences. In Ghana I observed in doctors the real passion and drive needed for medicine as well as many other essential qualities I believed doctors needed. This contrasts with the current selection criteria in the UK; sadly we are missing out on too many good doctors because of our obsession with grades rather than looking for real qualities that are going to make a difference to our patients.I discovered that seeing the immense suffering, and the close bond of doctors and patients in an entirely different social and economic context, helped me to evaluate and shape my own emotions and personal values. My motivation in wanting to become a doctor has increased tremendously since this trip. My trip to Ghana also inspired me to create a medical journal in my school as a fund-raising initiative. I brought together a group of fellow students to write articles about common teenage problems (teenage drinking, anorexia, obsessive compulsive disorder (OCD), stress, smoking, sexually transmitted diseases (STDs)) as well as articles on euthanasia and assisted suicide, stem cell research and the NHS. I wrote about my personal experiences in Ghana in addition to editing and publishing the school journal. All the funds raised from the school medical journal will be going to the HIV victims in Ghana.
None declared ASIf RAJAH, Sixth Form Student, St Albans School, Abbey Gateway, St Albans, Hertfordshire, AL3 4HB. CORRESPONDENCE: Asif Rajah, 41 Prospect Lane, Harpenden, Hertfordshire, AL5 2PL. |
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It is a reasonable generalisation that most doctors aim to be skilled in the practice of medicine; they try to be ‘good’ doctors. Also, despite frequent news stories illustrating the shortcoming of doctors, surveys show that contemporary society holds the medical profession in high regard; 1 doctors are generally considered to be ‘good’ people despite obvious exceptions such as Dr Harold Shipman.
But what do we mean by ‘goodness’ in medical practice? This essay uses sources from the arts and the humanities to explore this concept of ‘goodness’ and to consider the qualities of a ‘good’ doctor in a contemporary medical context.
Let us start with a consideration of a picture of a ‘good’ doctor. Van Gogh (1853–1890), produced several portraits of his own physician, Dr Paul-Ferdinand Gachet. Van Gogh was a prolific artist, producing more than two thousand paintings, drawings, and sketches, also leaving detailed descriptions of his colourful life in letters and diaries. In a letter to his sister, Wilhemina Van Gogh, he wrote that in this painting he had tried to portray Gachet's ‘sad but gentle, yet clear and intelligent’ expression. 2 A foxglove on the table represents Gachet's medical status and, possibly, the digitalis he prescribed for Van Gogh's mania. (It has been proposed that xanthopsia caused by digoxin poisoning explains Van Gogh's preoccupation with the colour yellow, though this seems unlikely.)
Van Gogh started painting in Belgium moving to Paris in 1886 where he met the impressionist artists Pissarro, Monet, and Gauguin. Although his paintings now sell for millions of pounds he failed to make any money in his own lifetime, his penury a constant preoccupation. He was a heavy drinker with a taste for absinthe and had bursts of manic activity followed by periods of depression. To improve his health he moved south to Arles to be joined by Gaugin. But, in a fit of mania or possible temporal lobe epilepsy, Van Gogh pursued his friend with an open razor and ended up cutting off a portion of his own earlobe. In 1890 after a stay in an asylum in Saint-Remy he went to live in Auvers-sur-Oise under the watchful eye of Dr Gachet. However, 2 months later he was dead, having shot himself. Gachet, himself an amateur painter, had been chosen to be Van Gogh's physician by his brother Théo. He hoped that Gachet's sensitivity toward artists would make him a ‘good’ doctor for Van Gogh's recurring bouts of mental illness. But was Gachet any help to Van Gogh? This extract is from a letter to Théo a month before he died: ‘Now about Doctor Gachet … first of all, he is sicker than I am, I think, or shall we say just as much, … Now when one blind man leads another blind man, don't they both fall into the ditch?’ 3
Although there was not much available to any physician of the day which could have reversed the course of Van Gogh's illness, his suicide after just 10 weeks in Gachet's care has led to questioning and criticism of this ‘good’ doctor's role.
Attempts to define the concept of ‘goodness’ can be traced back to Aristotle (384–322 BC). His theory of ‘virtue ethics' proposed that people with certain intrinsic good character traits make good decisions, and we should aspire to exhibit such qualities. Spicer 4 considers the virtues that a modern healthcare professional should possess and lists determination, consistency, and a sense of humanity.’ Altruism could be added to this list, although Jones writes that there is a growing feeling that altruism in medicine may be declining ‘if not dying’. 5 A moving account of a family doctor, Dr John Sassal, exploring the demands and rewards of medical virtue can be found in John Berger's book A Fortunate Man . 6 The book includes accounts of Sassal's battle with recurrent depression, a sad footnote being his suicide some years after the book was published.
The many philosophical and moral discourses with direct relevance to the concept of ‘goodness’ in the context of medical practice include Kant's ‘moral imperatives’ and Mills' ‘utilitarianism’. 7 Kant (1724–1804), wrote that to be virtuous, we do our duty and ignore our own inclinations or judgements. For a doctor this may lead to conflict; consider the clash of a doctor's duty of care to a patient requesting termination of pregnancy and the Roman Catholic faith. John Stuart Mill (1806–1873), proposed that the rightness or wrongness of an action is determined only by the consequences, an action producing the greatest good being, by definition, the right action. However, the application of Mills' utilitarian principle can lead to difficulties for the ‘good’ doctor. Individual medical decisions may conflict with NHS provision as patients have to wait their turn or even be denied beneficial treatment when health care is based on assessment of the ‘greater good’ of a population. The contemporary debate concerning the NHS provision of certain anti-cancer drugs and the right of individuals to pay to ‘top up’ their treatment illustrates this dilemma.
A contemporary doctor has to combine individual clinical expertise with the best available evidence as today ‘goodness’ is defined in terms of competence and performance. 8 Certainly the current focus of healthcare management is to assess ‘goodness’ in individuals and healthcare systems in terms of measurable data. But this reliance on qualitative and quantitative information does not provide the means to protect society from ‘bad’ doctors. Consider the case of Dr Harold Shipman; although the death rate of Shipman's patient list turned out to be high when examined retrospectively, this ‘bad’ doctor was medically skilled and performance outcome measures would give no indication of ‘goodness’ or ‘badness’ in such an instance.
Contemporary medical practice has changed almost unrecognisably since Van Gogh painted the portrait of Dr Gachet in 1890. Life expectancy in the UK has climbed steadily over the past 100 years but the expected time living in poor health is also increasing with a resultant increase in demand for healthcare provision. We are developing new epidemics; obesity, heart disease, alcohol and drug misuse, and diseases associated with the aging process. As preventive medicine pursues ever more risk factors, definitions of disease include more people as patients, which leads to the increasing medicalisation of modern life. In primary care, consultations are becoming more complex as a result of the increasing demands of patients who may have a changing perception of what it means to be well.
Society is changing; we now live in a post-modern, consumerist world. Patient consumerism is endorsed by current political attitudes which support immediate access to health care by the establishment of walk-in centres and the 24-hour telephone advice service NHS Direct. Lord Darzi, the minister in charge of the current review of the NHS is of the view that doctors must treat patients as customers able to shop around for the service they feel most appropriate. Spense 9 writes: ‘One of the most potent forces of irrationality in health care, has been promoted by the government. It has elevated consumer choice — and subjective belief — over medical expertise’ . This results in a society that is strong on rights but short on responsibility leaving a chasm between expectation and reality.
Conditions of employment have changed significantly for GPs as a result of the new GP contract which removed responsibility for the round-the-clock care of patients. The contract was welcomed by the majority of GPs as it allowed them the possibility of achieving an acceptable work-life balance instead of being overwhelmed by the increasing demands of a consumerist society. The new contract's Quality and Outcomes Framework (QOF), based on the achievement of measurable evidence-based ‘quality’ targets, has also influenced medical practice. Doctors are becoming accustomed to non-medical managers setting measurable outcomes and to receiving payment based on results. There are concerns that as a result, the practice of medicine is changing from being a vocation to a business, reducing GPs' sense of professionalism and diminishing their status in the eyes of the public. Greaves 10 feels that the role of the GP is being eroded by the imposition of such outcome-based practice but acknowledges that any resistance to this has become increasingly untenable in recent years. As a result, notes Greaves, GPs are ‘doing better but feeling worse’. A vast organisation such as the NHS with an annual budget of £18 billion, 9% of the total GDP and 1.34 million employees (NHS workforce census) 11 can never be free of political influence and must be managed. But as Rowan Williams, the current Archbishop of Canterbury, 12 said: ‘It isn't easy to sustain the humane view of medicine (or anything else) when the rules of our humanity are apparently being rewritten to suit the imperatives of management and profit.’
Hippocrates (460–357 BCE), defined the role of the physician very simply; he ‘must have two specific objectives in view with regard to disease, namely to do good or to do no harm’. 13 The General Medical Council (GMC) defines our contemporary code of conduct in the document, Good Medical Practice , 14 but is considerably less concise than Hippocrates and not so easy to follow. This document's opening statements are: ‘Make the care of your patient your first concern’ and ‘Protect and promote the health of patients and the public’. The first point advocates a patient-centred approach and the second point requires the doctor to consider the bigger picture; healthcare provision on a larger scale. However these roles are not always compatible as contemporary doctors have access to limited healthcare resources. As the GMC stated in 2003: ‘There is a fundamental conflict between population-based public health objectives, which are centrally controlled and with a strong emphasis on cost-effectiveness and equity, and the individual focus of patient care’. 15
The practice of evidence-based medicine may seem to offer a safe framework for practice but most decision-making in practice is intuitive, requires judgement and involves risk. 16 Yet, as a consequence of media pressure and an increasingly litigious public, it is becoming almost impossible for doctors to live with uncertainty and this leads to the practice of defensive medicine, ‘a desperate euphemism for a profound corruption of the patient–doctor relationship’ writes Tallis. 12 He continues: ‘The fundamental injunction of Hippocrates — ‘first do no harm’ — will, since optimal care informed by the intention to do no harm will not necessarily prevent harm from being done, be displaced by one yet more fundamental: ‘first cover your ass and damn the harm’.’
The practice of defensive medicine allows us to abrogate our responsibilities as doctors by giving our own fears priority over those of our patients. ‘Good’ patient-centred doctors should beware of falling into a defensive trap when their actions are directed by a need to ‘cover’ themselves in case of any accusations or omissions.
Society has a high expectation of the ‘goodness’ or inherent virtue of doctors and this is apparent in the shock and horror felt when doctors fall from this standard. The atrocities of Harold Shipman were so beyond the comprehension of both his patients and colleagues that this may have allowed him to continue his actions without detection. The apparent involvement of doctors in terrorist atrocities in London and Glasgow in 2007 was accompanied by widespread disbelief about the actions of men supposed to be committed to saving, not to taking lives. Bewilderment stems not merely from the fact that there can be no more fundamental way of breaking the ‘Hippocratic Oath’, in which a doctor vows not to act ‘with direct intent deliberately to end a human life’; but also because such behaviour defies our expectations.
Trust in doctors has been rocked in recent years by a series of ‘scandals’ affecting the medical profession which have been widely reported in the media. These include the BSE ‘cover up’, the Alder Hey organs scandal, the MMR debate and of course the activities of Dr Harold Shipman. So, what do our patients consider to be the qualities and attributes of a ‘good’ doctor? ‘I remember the time Shipman gave to my Dad. He would come around at the drop of a hat. He was a marvellous GP apart from the fact that he killed my father.’ 17
This quote illustrates that the views of patients may be astoundingly subjective and many attempts to determine the characteristics that the general public consider important in doctors have been inconclusive.
If, as this essay has explored, analysis and surveys, codes of practice, guidelines and protocols cannot define the role of a ‘good’ doctor then how does the medical profession reconcile the many conflicts presented by the practice of contemporary medicine? A greater understanding of the historical perspective, the sociological influences and a philosophical objectivity may help doctors to adapt to the changing expectations of both the medical profession and society. Accounts from literature and fiction can also help. Traditional literature provides accounts of doctors who battle to be ‘good’ despite the constraints of society or the limited scope of the health service they are able to provide. Examples include George Eliot's Dr Lydgate in Middlemarch , 18 and AJ Cronin's Dr Manson in The Citadel . 19 A more contemporary account is found in Robertson Davies' novel The Cunning Man , 20 a fictional but thought-provoking account of the life and work of a truly humane doctor, whose use of empathy, intuition, and judgement relieved his patients' burdens. Reading such accounts provides the reader with an opportunity to reflect on their own attitudes to issues central to the practice of ‘good’ medicine.
Let us finish by going back to Dr Gachet and to consider if he was a ‘good’ doctor to the artist Van Gogh despite the inescapable fact that his patient committed suicide. In letters to his brother, Van Gogh suggests that Gachet achieved a shared understanding with the artist and gained his respect and trust. I feel it is possible to conclude that the ‘good’ Dr Gachet provided a degree of consolation to this deeply troubled and depressed man although this did not prevent his suicide. Van Gogh, who wrote that his own art was an attempt to express the terrible passions of humanity has left us with a collection of paintings of the utopia he dreamed of. His images of peaceful tranquility and of simple unpretentious people, including this portrait of Dr Gachet (Page 58), delight us to this day.
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Introduction.
The noblest profession is of a doctor. They are given the stature next to God in our society. Doctors devote their lives in treating ailing patients. It is his duty to treat and cure sick people. They serve humanity unconditionally. This is the most respected work in the society because doctors don’t discriminate against patients as per the religion, caste and creed while treating them. This profession demands time, intense labor and busy schedules. Many times they put their lives at risk while treating life-threatening disease. Patients too place their complete faith in the doctors.
The field of medicine is vast and so there are doctors specialized in these various fields. Doctors with such specialization includes:
Oncologist: Doctor who treats cancer patients
Dermatologist: Doctor specializes in treating skin and skin related diseases.
Pediatrician: Doctor specializes in treating children.
Cardiologist: Doctor deals with heart related problems.
Neurologist: This is a specialization where doctor treats problems related to nerves in our body
Gynecologist: it is a specialization in treating the health of female reproductive problems.
General Physician: They treat acute and chronic illness and provide preventive measures to the patients.
Psychiatrist: Psychiatrist treats mental health issues.
Apart from these specializations there are doctors for dental and animals also.
If you want to become a doctor, you have to secure the degree of MBBS which is a five years long course. To get admission into medical colleges, you have to pass the entrance exam called NEET after 12 th grade. To be eligible for this exam, you should take up science subjects such as Physics, Chemistry and Biology in high school and in 12 th grade.
After four and half years of MBBS study, you have to go through one year of internship and there you learn how to diagnose various diseases practically in different departments. After completion of internship, you have to take an oath that you will always be ethical in this profession and serve the humanity selflessly. Then you become a doctor. If you want to pursue advanced studies after MBBS then you have to study three years course of MD or MS in specialized departments.
The lives of the patients are in the hands of a doctor. So, it is very important that a doctor possesses the following qualities in order to correct diagnosis and treatment.
Compassion: A doctor has to be compassionate towards his patients. Patients respond well when doctors are empathetic to their needs and interact with them by exercising courtesy and compassion.
Strong Work Ethic: Every day brings new challenges in this profession. So it is important for a doctor to have a very strong work ethic. This means dedicating oneself completely regardless of what is happening in his personal life.
Professionalism: This quality is a must for a doctor. Patients place their full faith and confidence in a doctor so it is important for a doctor to be professional in their approach like being attentive and listening to the needs of the patient, a good observer, and having patience to deal with them.
Knowledge: A doctor should always update his medical knowledge with the latest medical news and trends so that he can use his knowledge and skill set at the moment’s notice.
Confidence: A good doctor should reinforce his knowledge with confidence. Only when a doctor is confident, he can give assurance to his patients.
Humility: It is important to be humble with the patients. A good doctor must be approachable and available whenever needed by his patients.
Passion: A good doctor must have the passion for his study and practice. Passion makes a doctor disciplined and he is willing to sacrifice anything for treating his patients.
Q1. What are the Different Types of Doctors?
Ans. Oncologist, cardiologist, gynecologist, neurologist, pediatrician, general physician, dermatologist are some of the different types of doctors.
Q2. Why are Doctors Given the Stature Next to God in our Society?
And. Doctors are given the stature next to God in our society because they save lives and treat people to become better.
Q3. What are the Qualities, a Good Doctor Should Possess?
Ans. The qualities that a doctor should have are compassion, strong work ethic, professionalism, knowledge, confidence, humility and passion.
Q4. When is National Doctor’s Day Celebrated?
Ans. National doctor’s day is celebrated on July1st to commemorate the service of the doctors.
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