"What makes a good doctor ?"

The topic of characteristics that constitute a “good doctor” is extensive, allowing for a range of approaches and much discussion. Desk research conducted by Steiner-Hofbauer et al. (2018) on twenty different studies of the concept of a “good doctor” yielded six attributes. The four most frequently mentioned are, firstly, general interpersonal skills, next, communication and patient involvement, then, medical competence and finally ethics.

The medical profession is one that requires intensive interpersonal interactions. Firstly, the quality of teamwork among medical professionals directly affects the patient’s safety, and means the difference between success and failure of the treatment. Secondly, for patients, interactions with physicians are often negative experiences as it is commonly associated with suffering, illness, uncertainty and bad news. Therefore, patients expect a high quality of interpersonal skills from doctors. The category of general interpersonal skills comprises personal attributes and behaviour — these are not directly connected to medicine in the way competence, knowledge, and skill are. However, being cordial and polite, making patients feel at ease, showing empathy, and remaining calm under pressure are all attributes patients would wish their physician to have.

When individuals with different backgrounds are required to reach a decision together in often stressful and traumatic situations, communication is of vital importance. Doctors must listen carefully to the requirements of their patients and communicate information appropriately, tailored to the sensitivity of their patients. Furthermore, doctors must be able to explain tests and test results, answer questions honestly, and follow the fundamentals of polite conversation, i.e., allowing the patient adequate time to speak about their history and symptoms without interruptions. Patient involvement and understanding in medical decisions are only possible with the dispensing of clear, necessary information.

The core competence — the medical expertise and manual medical skill — of a doctor is unarguably the major constituent of medical education. Examples include as follows: taking a good history, making the correct diagnosis, and prescribing suitable therapies. Doctors also have to take responsibility for their quality of work and decisions.

Although ethics is more firmly embedded now in medical education than formerly, applying medical ethics in a pluralistic society is extremely challenging. In the face of much diversity, doctors must follow a strict code of conduct. Medical ethics date back to the Hippocratic Oath of the fifth century BCE. Today, a common framework is the “four principles” established by Beauchamp and Childress (1979), which include as follows: autonomy, justice, beneficence, and non maleficence. Good doctors abide by these principles as well as maintain the patient’s confidentiality.

Doctors need to combine the characteristics constituting a “good doctor” with an ability to meet expanding patient expectations. Of the four attributes, an awareness of ethics is central to this process and in the doctor’s appraisal. Autonomy, one of four ethics principles mentioned above, is often a bone of contention and modern ethics makes abortion a point of conflict as is the right to an assisted death, and the withdrawal of life support. Additionally, ethics are of special importance once the innovations in clinical technology such as organ transplant, IVF, and genome engineering are considered. It is clear that today’s “good” doctors have to contend with delivering not only good medical practice, interpersonal skills and communication, but are also faced with more complex ethical judgements than ever before.

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Bibliography

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British Medical Association. Medical ethics today: the BMA's handbook of ethics and law. John Wiley & Sons, 2012.

Childress, James F., and Tom L. Beauchamp. Principles of biomedical ethics. New York: Oxford University Press, 2001.

Manser, Tanja. "Teamwork and patient safety in dynamic domains of healthcare: a review of the literature." Acta Anaesthesiologica Scandinavica 53.2 (2009): 143-151.

Riddick, Frank A Jr. “The code of medical ethics of the american medical association.” The Ochsner journal vol. 5,2 (2003): 6-10.

Steiner-Hofbauer, Verena, Beate Schrank, and Anita Holzinger. "What is a good doctor?." Wiener Medizinische Wochenschrift 168.15-16 (2018): 398-405.