Professionalism

Definition and Goals
The cornerstone of professionalism is responsibility for patients’ care. In addition, a goal of professionalism is acting at all times “in the best interests of the child.” Child and adolescent psychiatrists must act in a professional manner. This is indicated by placing patient care above and beyond self interests, maintaining continuity of care, responding effectively and appropriately to patient needs, acting ethically and demonstrating respect for the patient and colleagues.

Knowledge
In order to act in a professional manner, residents need a firm knowledge base in specific areas. By graduation, they must demonstrate:

1. Understanding of professional codes of ethics, such as the one specified by the American Academy of Child and Adolescent Psychiatry
   
   
2. Understanding of legal and ethical principles of:
   
   • confidentiality
   
   • rights of minors and/or guardians to refuse treatment
   
   • requirements for mandated reporting of suspected abuse and/or neglect
   
   • involuntary commitment
   
   • assent and consent principles in research
   
   • abandonment
   
   
3. Knowledge of cultural diversity that includes:
   
   • cultural diversity of the U.S. population and cultural differences in children’s
   development
   
   • cultural influences on the identification of mental health problems and help-seeking behavior
   
   • ethno-cultural influences in biological and psychosocial interventions

Skills
The resident will demonstrate the skills associated with professionalism that include:

1. Responsibility for patient care, including:
   
   • responding to patient and caregiver communications
   
   • use of the medical record for appropriate documentation of the course of illness and its treatment
   
   • providing coverage if unavailable, e.g., out of town, on vacation
   
   • coordinating care with other members of the medical and/or multidisciplinary team
   
   • providing for appropriate transfer or referral, if this is necessary
   
   
2. The resident will respond to communications from patients, caregivers and health professionals in a timely manner. If unavailable, the resident will establish and communicate back-up arrangements. The resident communicates clearly to patients about how to seek emergent and urgent care when necessary
   
   
3. Ethical behavior as defined in the American Academy Code of Ethics, or Principles of Medical Ethics with Special Annotations for Psychiatry (APA)
   
   
4. Respect for patients and colleagues as persons, including their age, culture, disabilities, ethnicity, gender and sexual orientation
   
   
5. Assurance of continuity of care for patients and when it is appropriate to terminate care, the resident will do so appropriately and not “abandon” patients
   
   
6. Use of appropriate forms and procedures for informed consent, involuntary commitment and reports of suspected abuse and/or neglect

Attitudes
Professionalism requires demonstration of the followin attitudes:

1. Respect, regard and integrity and a responsiveness to the needs of patients and society that supersedes self-interest
   
   
2. Holding responsibility for excellence in patient care as the highest standard
   
   
3. Commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent and business practices
   
   • Knowing when and how to challenge/provide procedures and practices for the patient’s benefit, consistent with ongoing research and practice development in child and adolescent psychiatry
   
   • Sensitivity and responsiveness to cultural differences, including awareness of their own cultural perspectives