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Goran Mijaljica, M.D.

Liječnička profesija (jezik, titule, simbolineuron.mefst.hr/docs/katedre/med_humanistika...Hrvatskaliječničkakomora– Croa5an"Medical"Chamber"! TheCroatianMedicalChamber(hereinafter&referred&to&as&

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Goran  Mijaljica,  M.D.      

A  Professional  � Definition  of  PROFESSIONAL  b  :  engaged  in  one  of  the  learned  professions  c  (1)  :  characterized  by  or  conforming  to  the  technical  or  ethical  standards  of  a  profession  (2)  :  exhibiting  a  courteous,  conscientious,  and  generally  businesslike  manner  in  the  workplace  :  having  a  particular  profession  as  a  permanent  career  <a  professional  soldier>    Merriam-­‐Webster  

Profession  �  a  :  a  calling  requiring  specialized  knowledge  and  often  long  and  intensive  academic  preparation  

� b  :  a  principal  calling,  vocation,  or  employment  

�  c  :  the  whole  body  of  persons  engaged  in  a  calling  

Merriam-­‐Webster  

Profession  � Vocation/calling  –  type  of  work  permanently  performed  by  an  individual.    

� Profession  –  sociologically,  a  profession  is  a  vocation  which  has  a  monopoly  on  a  certain  part  of  complex  knowledge  and  practical  skills  which  require  extensive  education  –  higher  education  –  and  by  that  becomes  distinctive  in  the  society.  

Medical  profession  � The  first  phase  of  a  profession  in  reaching  full  professional  autonomy  is  public  affirmation  and  professional  control  of  the  members  of  the  profession  

� After  public  affirmation  and  implementation  of  professional  control  of  the  members  of  the  profession,  specific  characteristics  of  a  profession  can  further  develop.    

Specific  characteris5cs  of  a  profession  1.  A  profession  sets  its  own  standards  of  education  and  

preparation  for  practice  2.  Students  of  a  certain  profession  go  through  a  more  

rigorous  specialization  than  students  of  other  vocations    

3.  Professional  practice  is  usually  accredited  by  a  certain  form  of  a  licence  

4.  Licencing  institutions  are  run  by  members  of  the  profession  

5.  Most  legal  regulations  related  to  the  profession  are  shaped  by  members  of  the  profession.  

Specific  characteris5cs  of  a  profession  6.  Since  a  profession  also  implies  high  income,  power  

and  prestige,  it  is  very  selective  in  accepting  students    7.  A  professional  is  relatively  free  of  lay  evaluation  and  

control.    8.  Members  of  the  profession  are  more  firmly  identified  

and  attached  to  their  profession  than  people  with  other  vocations.    

Medical  doctors  as  a  “pure”  profession:  1.  Have  a  clearly  defined  education  in  a  broad  spectrum  

of  theoretical  knowledge  and  practical  skills    2.  Persons  without  required  credentials,  and  practice  

medicine,  are  subject  to  sanctions  3.  The  public  can  easily  identify  medical  doctors  and  

knows  what  to  expect  from  them  (which  type  of  expertise)    

4.  Professional  organization  advocates  for  interests  of  its  members,  and  has  its  publications  

5.  Has  a  written  Code  of  Ethics,  and  strong  intraprofessional  responsibility  

Symbols  of  medicine  � White  coat  �  Stethoscope  � Doctor’s  office,  clinic  � Operating  room  �  Laboratory  � Hospital  � Modern  technology  � Titles…  

Rod  of  Asclepius  � Asclepius,  son  of  Apollo,  who  practiced  medicine  in  ancient  Greek  mithology  

Title  � A  title  concisely  testifies  to  profession,  degree  and  type  of  the  carrier’s  education,  and  the  vocation  the  carrier  performs  

� Historical  background  is  found  in  preindustrial  society  –  medieval  nobility  titles  had  a  stratificational  role:  to  differentiate  nobility  and  to  achieve  simbolic  distance  between  the  aristocracy  and  others.  

�  Symbols,  signs  and  titles  are  used  for  inner  and  outer  identification  of  a  profession.    

�  Identification  is  done  on  few  levels:  1.  Identification  with  professional  title  and  ideology  of  a  profession    

2. Identification  with  the  mode  of  practice  which  is  characteristic  for  a  profession    

3. Identification  with  organizational  or  institutional  position  of  the  profession    

4. Identification  with  the  social  position  of  the  profession.    

Titles  in  medicine  � Doctor  of  medicine:  Medicinae  doctor  (the  one  who  teaches  medicine).  Degree  awarded  by  accredited  medical  schools.    

� Dr.  med.  (engl.  MD,  M.D.)  �  In  Croatia,  the  professional  title  “doctor  of  medicine”  is  awarded  after  a  six-­‐year  medical  program  

� MBBS  (BMBS)  –  Bachelor  of  Medicine,  Bachelor  of  Surgery  

Titles  in  medicine  � Residency,  Specialization:  Medical  doctors  may  receive  additional  education  through  a  residency/specialization  

� A  residency/specialization  is  a  form  of  organized  acquisition  of  theoretical  and  practical  knowledge  according  to  a  certified  program  

� After  a  board  examination,  medical  doctors  become  specialists  of  a  certain  medical  specialty  

Primarius  � Awarded upon: � Successful ten-year work in a medical specialty, by

enhancing the profession by introducing or applying diagnostic, therapeutic or rehabilitation procedures, conformance and promotion of ethical standards, humane approach to patients and colleagues.

� Sucessful activities in the fied of education of healh care professionals

� Sucessful publications.  

Titles  � Doctor  of  science  (dr.  sc.)  –  note  that  Croatian  dr.  sc.  is  equivalent  to  PhD  in  other  countries  (such  as  USA)  

� Croatian  teaching  titles  in  higher  education:  Docent  (doc.),  izvanredni  profesor  (prof.),  redoviti  profesor  (prof.)  –  English:  assistant  professor,  associate  professor,  full  professor  

 

Professional  organiza5on  � Creating  a  professional  organization  is  important  for  the  process  of  professionalization  and  is  often  the  first  step  in  professionalization  of  an  occupation.  

 � The  purpose  and  goals  of  a  professional  organization:  � Oversight  of  the  professional  recruitment  � Ensuring  the  quality  of  professional  education  � Protecting  the  monopoly  of  the  professional  scope  of  activity,  etc.  

Nurse  Prac**oners:  Growing  Compe**on  for  Family  Physicians?  �  “Across  the  country,  nurse  practitioners  and  family  physicians  work  together  in  practices  where  their  skills  complement  each  other.  At  the  same  time,  some  doctors  argue  that,  without  ready  access  to  supervising  physicians,  nurse  practitioners  are  likely  to  order  more  tests  and  consultations  and  be  quicker  to  admit  patients  to  the  hospital,  thereby  driving  up  health  care  costs.”  

http://www.aafp.org/fpm/1998/1000/p34.html  

Hrvatska  liječnička  komora  –  Croa5an  Medical  Chamber  �  The  Croatian  Medical  Chamber  (hereinafter  referred  to  as  “the  Chamber”  or  HLK)  is  the  independent  regulator  and  professional  organization  of  health  care  professionals  -­‐  medical  doctors  in  the  Republic  of  Croatia.

�  The  Chamber  promotes  and  safeguards  the  rights  and  interests  of  medical  doctors,  works  on  upgrading  the  standards  of  medical  practice,  protects  the  reputation  of  medical  professionals  and  protects  patients  by  ensuring  good  practice  and  fostering  high  standards  of  care.  

www.hlk.hr

� Medical  doctors  practicing  medicine  in  the  Republic  of  Croatia  must  register  with  the  Chamber.  

Hrvatska  liječnička  komora  –  Croa5an  Medical  Chamber  � The  first  medical  chamber  was  founded  in  1903  for  the  town  of  Split  and  its  neighboring  areas.  In  1923  a  new  chamber  was  founded  for  Croatia,  Slavonia  and  Međimurje  with  its  main  office  in  Zagreb.  In  1929  Dalmatia  was  included  and  the  new  chamber  operated  as  the  Medical  Chamber  of  Savska  Banovina.    

Hrvatska  liječnička  komora  –  Croa5an  Medical  Chamber  �  In  1939  it  was  renamed  the  Medical  Chamber  of  Banovina  Hrvatska  and  in  1941  the  chamber  worked  as  the  Medical  Chamber  of  the  Independent  State  of  Croatia  (NDH)  until  1945  when  it  was  renamed  the  Medical  Chamber  of  the  Federal  State  of  Croatia  only  to  have  its  work  permit  renounced  later  that  same  year.  

Hrvatska  liječnička  komora  –  Croa5an  Medical  Chamber  �  In  1995  the  chamber  was  re-­‐established  pursuant  to  Section  43,  para.1  of  the  Croatian  Constitution  (the  Official  Gazette  of  the  Republic  of  Croatia  »Narodne  novine«  No.  56/90)  and  Section  171  para.1  of  the  Croatian  Health  Care  Act  (the  Official  Gazette  »Narodne  novine«  No.  75/93,  11/94,  1/97  integral  version,  117/97,  95/00  and  129/00),  under  a  new  name  -­‐  the  Croatian  Medical  Chamber.  On  June  27,  1995  the  Chamber  adopted  the  Statute.  

Hrvatska  liječnička  komora  –  Croa5an  Medical  Chamber  � The  total  number  of  medical  doctors  registered  with  the  Chamber:  17,102  

� The  total  number  of  licensed  medical  doctors  registered  with  the  Chamber:    16,972  

� The  total  number  of  medical  doctors  employed  in  health  care  facilities:  12,149  (according  to  the  2007  data  of  the  Croatian  National  Institute  of  Public  Health)  or  74%  of  the  total  number  of  licensed  medical  doctors.  

� The  total  number  of  specialists  in  health  care  facilities:  7,098  (41%  licensed  members)  

CODE  OF  MEDICAL  ETHICS  AND  DEONTOLOGY  1.  It  is  an  honorable  duty  imposed  upon  medical  

doctors  to  make  saving  human  life  their  priority  and  work  and  live  protecting  it  at  all  times.  

2.  Thus  all  medical  doctors  must  have  respect  for  human  life  from  its  beginning  until  its  end,  promote  health,  act  to  prevent  and  treat  illnesses  and  show  respect  for  human  body  and  each  person’s  identity  before  and  after  death.  

3.   Medical   doctors   will   not   discriminate   against   patients  allowing   any   patient’s   age,   gender,   race,   nationality,  religion,   political   views,   social   standing   or   any   other  criterion  to  affect  their  relationship  and  will  treat  patients  with  respect  to  their  human  rights  and  dignity.    4.   Medical   doctors   will   do   their   best   to   cherish   the  tradition  of  their  noble  profession  by  practicing  medicine  in   accordance   with   the   highest   standards   of   care,  profession   and   ethics   in   the   relationship   with   patients,  their   relatives,   others   close   to   them   and   people   in   good  health.    

5.  Medical  doctors  have  a  duty  to  protect  the  reputation  and   dignity   of   medical   profession   and   treat   their  colleagues  with  respect.    6.  Medical  doctors  are  obligated  to  use  their  knowledge  and   skill   responsibly   and   in   compliance   with   the  principles  established  in  this  Code  at  all  times.  

Hrvatski  liječnički  zbor  –  Croa5an  Medical  Associa5on  � The  Croatian  Medical  Association,  founded  on  February  26,  1874,  is  an  organisation  of  physicians  who  associate  in  order  to  promote  the  health  protection  of  the  citizens,  professional  and  scientific  practice,  to  foster  medical  ethics  and  to  protect  the  interests  of  their  profession.  

� www.hlz.hr  

World  Medical  Associa5on  � The  World  Medical  Association  (WMA)  is  an  international  organization  representing  physicians.  It  was  founded  on  17  September  1947,  when  physicians  from  27  different  countries  met  at  the  First  General  Assembly  of  the  WMA  in  Paris.  The  organization  was  created  to  ensure  the  independence  of  physicians,  and  to  work  for  the  highest  possible  standards  of  ethical  behaviour  and  care  by  physicians,  at  all  times.    

WMA  � This  was  particularly  important  to  physicians  after  the  Second  World  War,  and  therefore  the  WMA  has  always  been  an  independent  confederation  of  free  professional  associations.  Funding  has  been  by  the  annual  contributions  of  its  members,  which  has  now  grown  to  95  National  Medical  Associations.  

� The  WMA  provides  a  forum  for  its  member  associations  to  communicate  freely,  to  co-­‐operate  actively,  to  achieve  consensus  on  high  standards  of  medical  ethics  and  professional  competence,  and  to  promote  the  professional  freedom  of  physicians  worldwide.  

� This  unique  partnership  facilitates  high-­‐calibre,  humane  care  to  patients  in  a  healthy  environment,  enhancing  the  quality  of  life  for  all  people  in  the  world.  

� www.wma.net