Code of Professional Conduct
Policy
on Sexual Harassment
Policy on Anti-Discrimination
Patient
Bill of Rights
FGP
Faculty Physicians' Responsibilities Statement, On-Call Messaging
Standards
Patient Relations
Patient
Communication
CODE OF PROFESSIONAL CONDUCT
Endorsed by the
Graduate Medical Education Committee (1996, 2006)
for all Residents/Fellows in ACGME-accredited programs
College of Medicine
University of Arkansas for Medical Sciences
Preface
The University of Arkansas for
Medical Sciences College of Medicine (UAMS-COM) and clinical departments are
committed to excellence in: 1) patient care; 2) education and training of
medical students, graduate students, house officers, nurses, and other health
professionals; 3) continuing education of staff members; and 4) research. To
further the goal of excellence, all professionals at UAMS-COM are expected to
adhere to the Code of Professional Conduct in their interactions with patients,
colleagues, other health professionals, students, peers, and the public.
The Code of Professional Conduct is a series of principles and their subsidiary
rules that govern professional interactions. The Code consists of two
complementary sections: professional obligations and professional ideals.
"Obligations" refer to necessary professional behaviors that are required
by the ethical foundation of medical practice, teaching, learning, and research.
"Ideals" refer to desirable professional behaviors that professionals at
all levels should attempt to acquire because they enhance professional
excellence.
The Code applies to all professionals at UAMS-COM involved in its clinical, teaching, research, and administrative activities. Because of its broad reach, certain portions of the Code will be more directly applicable to some disciplines than to others. For example, the clinical portions apply to medical students, residents/fellows and faculty physicians, nurses, physician's assistants, nurse practitioners, and all other professionals engaged in patient care. Similarly, those portions pertaining to teaching and research apply to all professionals engaged in teaching and research regardless of discipline. The portions pertaining to students apply to Medical students and residents/fellows at all levels. The general portions of the Code discussing confidentiality, conflicts of interest, interpersonal relations, and the professional ideals apply to all UAMS-COM professionals.
A. Professional Obligations
1. Respect for persons
• Treat patients, colleagues,
other health professionals, students, peers, and teachers with the same degree
of respect you would wish them to show you.
• Treat patients with kindness, gentleness, and dignity.
• Do not use offensive language, verbally or in writing, when referring to
patients or their illnesses.
• Respect the privacy and modesty of patients.
• Do not harass others physically, verbally, psychologically, or sexually.
• Do not discriminate on the basis of sex, religion, race, disability, age, or
sexual orientation.
2. Respect for patient confidentiality
• Do not share the medical or personal details of a patient with anyone except
those health care professionals integral to the well being of the patient or
within the context of an educational endeavor.
• Do not discuss patients or their illnesses in public places where the
conversation may be overheard.
• Do not publicly identify patients, in spoken words or in writing, without
adequate justification.
• Do not invite or permit unauthorized persons into patient care areas of the
institution.
• Do not share your confidential Clinic Information Systems passwords with
unauthorized persons.
• Do not look up confidential data on patients without a professional "need to
know".
• Do not misuse electronic mail.
3. Honesty, Integrity
• Be truthful in verbal and in
written communications.
• Acknowledge your errors of omission and commission to colleagues and patients.
• Do not knowingly mislead others.
• Do not cheat, plagiarize, or otherwise act dishonestly.
• Do not abuse special privileges, e.g., making unauthorized long-distance
telephone calls.
4. Responsibility for patient care
• Obtain the patient's informed
consent for diagnostic tests or therapies.
• Assume 24-hour responsibility for the patients under your care; when off duty,
or on vacation, assure that your patients are adequately cared for by
another practitioner.
• Follow up on ordered laboratory tests and complete patient record
documentation conscientiously.
• Coordinate with your team the timing of information sharing with patients and
their families to present a coherent and consistent treatment plan.
• Charge patients or their insurers only for clinical services provided or
supervised.
• Do not abuse alcohol or drugs that could diminish the quality of patient care
or academic performance.
• Do not have romantic or sexual relationships with patients.
5. Awareness of limitations,
professional growth
• Be aware of your personal
limitations and deficiencies in knowledge and abilities and know when and of
whom to ask for supervision, assistance, or consultation.
• Know when and for whom to provide appropriate supervision.
• Do not engage in unsupervised involvement in areas or situations where you are
not adequately trained.
• Avoid patient involvement when you are ill, distraught, or overcome with
personal problems.
• Students, residents and fellows should have all patient workups and orders
countersigned by the appropriate supervisor.
6. Deportment as a professional
• Clearly identify yourself and your
professional level to patients and staff; wear your name tag when in patient
areas.
• Do not introduce medical students as "doctor" or allow yourself as a medical
student to be introduced as "doctor."
• Maintain a professional composure despite the stresses of fatigue,
professional pressures, or personal problems.
• Do not write offensive or judgmental comments in patients' charts.
• Dress in a neat, clean, professionally appropriate manner.
7. Avoiding conflicts of interest
• Resolve all clinical conflicts of
interest in favor of the patient.
• Do not accept non-educational gifts of value from drug companies or medical
equipment vendors or suppliers.
• Do not participate in incentive programs, especially when this involves
prescribing drugs made by the company.
• Do not refer patients to laboratories or other agencies in which you have a
direct financial stake.
• Do not accept a "kickback" for any patient referral.
8. Responsibility for peer behavior
• Take the initiative to identify and
help rehabilitate impaired students, physicians, nurses, and other employees
with the assistance of the UAMS or ACH Medical Staff Health Committees, the
Employee Assistance Program, or the employee's supervisor.
• Report serious breaches of the Code of Professional Conduct to the appropriate
person.
• Indicate disapproval or seek appropriate intervention if you observe less
serious breaches.
9. Respect for personal ethics
• You are not required to perform
procedures (e.g. elective abortions, termination of medical treatment) that you,
personally, believe are unethical, illegal, or may be detrimental to patients.
• You have an obligation, however, to inform patients and their families of
available treatment options that are consistent with acceptable standards of
medical and nursing care.
10. Respect for property and laws
• Do not misappropriate, destroy,
damage, or misuse property of UAMS or its component institutions.
• Adhere to the regulations and policies of UAMS, and its component
institutions, such as policies governing fire safety, hazardous waste disposal,
and universal precautions.
• Adhere to local, state, and federal laws, and regulations.
11. Integrity in Research
• Report research results honestly in
scientific and scholarly presentations and publications.
• Give proper credit and responsibility to colleagues and others who
participated in the research when publishing and presenting reports.
• Report research findings to the public and press honestly and without
exaggeration.
• Avoid potential conflicts of interest in research; disclose funding sources,
company ownership, and other potential conflicts of interest in written and
spoken research presentations.
• Adhere to the institutional regulations governing research using human
subjects and animals.
B. Professional Ideals
1. Clinical virtues
• Attempt to cultivate and practice
clinical virtues, such as caring, empathy, and compassion.
2. Conscientiousness
• Fulfill your professional
responsibilities with conscientiousness.
• Notify the responsible supervisor if something interferes with your ability to
perform clinical tasks effectively.
• Learn from experience and grow from the knowledge gained from errors so as not
to make the same mistake repeatedly.
• Dedicate yourself to lifelong learning and self-improvement by implementing a
personal program of continuing education and continuous quality improvement.
• Students and residents/fellows should complete all assignments accurately,
thoroughly, legibly, and in a timely manner.
• Students and residents/fellows should attend scheduled classes, laboratories,
seminars, and conferences except for justified absences.
3. Collegiality
• Cooperate with other members of the
health care team in clinical activities and with other members of the research
team in research activities.
• Teach others at all levels of education and training.
• Be generous with your time to answer questions from residents/fellows,
patients, and patients' family members.
• Shoulder a fair share of the institutional administrative burden.
• Adopt a spirit of volunteerism and altruism in teaching and patient care
tasks.
• Use communal resources (equipment, supplies, and funds) responsibly and
equitably.
4. Personal health
• Develop a life style of dietary
habits, recreation, disease prevention, exercise, and outside interests to
optimize physical and emotional health to enhance professional performance.
5. Objectivity
• Avoid providing professional care
to members of your family or to persons with whom you have a romantic
relationship.
6. Responsibility to society
• Avoid unnecessary patient or
societal health care monetary expenditures.
• Provide services to needy patients regardless of their ability to pay.
(Adapted from
Dartmouth-Hitchcock Medical Center, Code of Professional Conduct, 1996)
Faculty Physicians' Responsibilities Statement Faculty Group Practice
Patient First Philosophy
The Faculty Group Practice was founded to provide
comprehensive and quality care for patients. The role of the
faculty physicians and staff is to provide compassionate care for
the maximum benefit of the patient. Every patient will receive
all needed services in an environment where there is genuine
concern for the patient.
The faculty physicians of UAMS Medical Center demonstrate professional, respectful behavior to patients at all times, consistent with the group's philosophy to put the welfare of patients first.
Outpatient Practice Statement
1. Recognizing that accessibility is a key component of
excellent patient care, we, as faculty physicians will
participate in the development of a reasonable and accessible
scheduling mechanism for clinics, preferably through a
centralized scheduling system.
2. Our goal is to make new patient appointments available with a health care
provider in every clinic within 14 days or within a reasonable period of time
which meets the medical needs of the patient and is acceptable to both the
patient and the referring physician.
3. Patient appointments are made during the initial contact telephone call from
the patient or referring physician.
4. Provisions for "overbooks" are developed for each clinic, so that
arrangements can be made for seeing "urgent" patients promptly.
5. Our goal is to avoid the cancellation of clinics. When missing a clinic is
unavoidable, , we try to arrange for coverage by an appropriate colleague. We
plan our attendance at medical meetings, conferences, lectures, etc., as much as
possible around clinic schedules and block scheduling for these clinics when a
conflict is unavoidable, rather than canceling clinics after patients have been
scheduled.
6. As the faculty physician, we are in the clinic on time for the first
scheduled patient. When tardiness is unavoidable, we offer an apology to the
patients who have been waiting. We have responsibility for the clinic schedule.
7. As faculty physicians, we are involved in all aspects of our patient’s care.
We use CMS guidelines regarding the presence of faculty physicians. We inform
each patient that we are responsible for each visit.
8. Before we leave the exam room, we ask each patient if there are any further
questions concerning their condition or plan of treatment.
9. As faculty physicians, we communicate with appropriate physicians and
services involved in our patient’s ongoing care.
10. We work with the Medical Director of the clinic, clinic management, and our
fellow physicians to utilize clinic resources effectively and efficiently.
Inpatient Practice Statement
1. When on service for inpatients, we see each of our
patients daily, and document our care in the patient's record. We
inform each patient which faculty physician is responsible for
his or her care.
2. Each service will ensure that a qualified faculty physician is
available at all times.
3. Each service ensures that an attending faculty physician is
accessible by telephone promptly to referring physicians,
patients, colleagues, the Emergency Room, and nursing units.
4. As faculty physicians, we respond quickly to non-emergent
calls from referring physicians, and we help to establish a
mechanism to notify us promptly of such calls.
5. As members of the Faculty Group Practice, we collaborate in
the development of a campus-wide Medical Exchange Service. We
will participate in the development of a clearly designed on-call
schedule that includes accurate pager and phone numbers, which is
available to provide 24-hour access.
6. Inpatient consults are seen as soon as possible. We provide
consultations according to the following guidelines: routine:
within 24 hours; urgent: within 4 hours; emergency: immediately
(less than 1 hour). When
patients are seen by a resident on a consulting service, documentation of
his/her discussion of the case with the attending physician will be placed in
the medical record promptly. Consult attendings will provide written consult
documentation in the medical record.
7. Pre-operative consultations for elective surgery are
coordinated between the surgical and consulting services. When
possible, consultations occur prior to hospitalization to avoid
unnecessary delays in surgery or additional days in the hospital
for the patient.
8. Upon completion of an operation or a procedure, we notify the
family of the outcome prior to the delivery of a patient to the
Recovery Room. We also notify the family of the location of the
Recovery Room and tell them when they will be able to visit the
patient.
9. After an operation or a procedure, we provide the family with
all information pertinent to the patient's welfare, including
answering questions.
10. As faculty physicians, we ensure that the discharge treatment
plan, home health, and follow-up care are well planned and
implemented. Each patient is given clear instructions as to whom
should be contacted to discuss problems and how to make this
contact. We ensure that all home health orders clearly delineate
the responsible faculty or community physician.
11. As faculty physicians, we communicate with appropriate
physicians and services involved in our patient's ongoing care.
On-Call
& Messaging Standards
1. As clinical systems are activated, all University
Hospital-based Faculty Group Practice physicians and housestaff
will utilize the centralized, on line messaging system.
2. Department/division office staff or physicians will be
responsible for inputting and updating schedules. All call
schedules will be entered/revised/maintained in the electronic
AmTelCo database.
3. All physicians will be responsible for responding to pages
according to the following guidelines and indicators: -8
indicated a call from a physician, pages will be returned within
5 minutes; -1 indicates an emergency call, pages will be returned
within 5 minutes. If not returned within five minutes, the
next designated physician on call will be
paged. All other pages will be returned within 15 minutes.
4. External referring physicians calling the Access Center will
be asked if they would like to speak to a UAMS attending
physician. If they would, they will be immediately routed to the
attending on call for the particular service, via phone or pager.
If the referring physician has no preference he/she will be
directed to the physician (either resident or faculty) currently
taking first call.
Patient
Communication is More Than What We Say
Many patients come away from a conversation remembering
more of the nonverbal messages than the spoken words. Rarely do we think
about the more subtle messages that we send with our eyes, face, hands and
posture; however, nonverbal cues tend to be more revealing of a speaker's true
intent and attitude. Below are some nonverbal gestures that can work for
physicians. Try each one as naturally as possible to see which might work
for you.
| Nonverbal Gesture | Translation |
| Sit down across from the patient when communicating. | "I'm not in a hurry, and I'll talk directly to you." |
| Place your hands in front of you with your fingertips, but not palms, touching. | "I'm listening carefully. I'm thinking. Let's consider all options." |
| Maintain eye contact with the patient. | "I see you as a person." |
| Briefly place your hand on the patient's shoulder, or pat his or her back. | "You're not in this alone. I'm here for you, you're going to do fine." |
| Slightly raise your eyebrows. | "I'm listening to what you're saying." |
| Lean forward in your chair to close the distance between you and the patient. | "Let's talk as specifically as possible. Let's make sure we understand each other." |
Communication with words and gestures is the richest and most beneficial form of communication for helping patients understand and follow your advice and for avoiding miscommunication.
Date this page was last edited 03/05/08