Professionalism Health Dictionary

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Professionalism: From 1 Different Sources

n. possession of a high level of intellectual and technical expertise with a commitment to public service and the ability to practise autonomously within the regulations of the discipline. It calls for a special set of *values, behaviours, and relationships including respect and care for oneself as well as patients and others, honesty, *integrity, reliability, *responsibility, communication, collaboration, *compassion, *empathy, altruism, and *advocacy – but also self-awareness and a knowledge of limits (see burnout). Major shortcomings might be reported to a professional body (such as the *General Medical Council for UK doctors).
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Sports Medicine

The ?eld of medicine concerned with physical ?tness and the diagnosis and treatment of both acute and chronic sports injuries sustained during training and competition. Acute injuries are extremely common in contact sports, and their initial treatment is similar to that of those sustained in other ways, such as falls and road traf?c incidents. Tears of the muscles (see MUSCLES, DISORDERS OF), CONNECTIVE TISSUE and LIGAMENTS which are partial (sprains) are initially treated with rest, ice, compression, and elevation (RICE) of the affected part. Complete tears (rupture) of ligaments (see diagrams) or muscles, or fractures (see BONE, DISORDERS OF – Bone fractures) require more prolonged immobilisation, often in plaster, or surgical intervention may be considered. The rehabilitation of injured athletes requires special expertise

– an early graded return to activity gives the best long-term results, but doing too much too soon runs the risk of exacerbating the original injury.

Chronic (overuse) injuries affecting the bones (see BONE), tendons (see TENDON) or BURSAE of the JOINTS are common in many sports. Examples include chronic INFLAMMATION of the common extensor tendon where it

attaches to the later EPICONDYLE of the humerus – common in throwers and racquet sportspeople – and stress fractures of the TIBIA or METATARSAL BONES of the foot in runners. After an initial period of rest, management often involves coaching that enables the athlete to perform the repetitive movement in a less injury-susceptible manner.

Exercise physiology is the science of measuring athletic performance and physical ?tness for exercise. This knowledge is applied to devising and supervising training regimens based on scienti?c principles. Physical ?tness depends upon the rate at which the body can deliver oxygen to the muscles, known as the VO2max, which is technically di?cult to measure. The PULSE rate during and after a bout of exercise serves as a good proxy of this measurement.

Regulation of sport Sports medicine’s role is to minimise hazards for participants by, for example, framing rule-changes which forbid collapsing the scrum, which has reduced the risk of neck injury in rugby; and in the detection of the use of drugs taken to enhance athletic performance. Such attempts to gain an edge in competition undermine the sporting ideal and are banned by leading sports regulatory bodies. The Olympic Movement Anti-Doping Code lists prohibited substances and methods that could be used to enhance performance. These include some prohibited in certain circumstances as well as those completely banned. The latter include:

stimulants such as AMPHETAMINES, bromantan, ca?eine, carphedon, COCAINE, EPHEDRINE and certain beta-2 agonists.

NARCOTICS such as DIAMORPHINE (heroin), MORPHINE, METHADONE HYDROCHLORIDE and PETHIDINE HYDROCHLORIDE.

ANABOLIC STEROIDS such as methandione, NANDROLONE, stanazol, TESTOSTERONE, clenbuterol, androstenedone and certain beta-2 agonists.

peptide HORMONES, mimetics and analogues such as GROWTH HORMONE, CORTICOTROPHIN, CHORIONIC GONADOTROPHIC HORMONE, pituitary and synthetic GONADOTROPHINS, ERYTHROPOIETIN and INSULIN. (The list produced above is not comprehen

sive: full details are available from the governing bodies of relevant sports.) Among banned methods are blood doping (pre-competition administration of an athlete’s own previously provided and stored blood), administration of arti?cial oxygen carriers or plasma expanders. Also forbidden is any pharmacological, chemical or physical manipulation to affect the results of authorised testing.

Drug use can be detected by analysis of the URINE, but testing only at the time of competition is unlikely to detect drug use designed to enhance early-season training; hence random testing of competitive athletes is also used.

The increasing professionalism and competitiveness (among amateurs and juveniles as well as professionals) in sports sometimes results in pressures on participants to get ?t quickly after injury or illness. This can lead to

players returning to their activity before they are properly ?t – sometimes by using physical or pharmaceutical aids. This practice can adversely affect their long-term physical capabilities and perhaps their general health.... sports medicine

Harm

n. physical, mental, or moral damage or the threat of this. Avoiding it is one of the ethical *four principles known as *nonmaleficence. Although health service staff have a clear duty to benefit patients and avoid harming them, in practice almost all medical actions run the risk of harming the patient and in some no good effect can be achieved without a clearly harmful process (such as mastectomy or chemotherapy for breast cancer). Therefore all medical professionals should learn how to make a *risk–benefit analysis at each point of care. The risk of harm should be explained to patients and their agreement obtained at each appropriate point. Professional blame or litigation may result if this is not done and harm results. See also primum non nocere; professionalism.... harm

Integrity

n. moral honesty, consistency, and truthfulness: one of the requirements of *professionalism. Integrity is particularly important in health care, where patients are vulnerable in all sorts of ways; it implies that someone can be trusted to behave well beyond their particular role.... integrity

Responsibility

n. the state or position of being accountable for one’s actions and decisions. In health care, responsibility for some matters may be delegated to a less experienced clinician but overall responsibility remains with the senior. At the same time, responsibility for personal health is with the individual, an approach underlined by *dependence agencies (such as Alcoholics Anonymous). Best health care in practice acknowledges this mutuality or partnership: the physician is an expert in medicine, the patient in him- or herself. See also professionalism.... responsibility

Truth-telling

n. telling the facts openly, honestly, and unambiguously. Clinicians should speak truthfully to their patients unless there are acceptable justifications not to do so that respect the patient’s *autonomy. Without knowing what is wrong, for instance, a patient cannot make a choice of treatments or decide whether to be treated at all. Candour or openness is a requirement of *professionalism but does not extend to inappropriate revelations from clinicians about their personal lives. See also therapeutic privilege.... truth-telling

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