Community Medicine EVALS # 1

Lecture #1: Leadership and Professionalism

Occupational Medicine
Lecture Content/Table of Contents

1. DEFINITION OF TERMS The branch of medicine that deals with the

2. LEADERSHIP
3. TEAMWORK
prevention and treatment of diseases and
4. PROFESSIONALISM injuries occurring at work or in specific
5. UNPROFESSIONAL BEHAVIORS occupations.
1. DEFINITION OF TERMS
Occupational Disease is one that is
associated with a particular occupation and
Table I. Clinical Medicine vs. Public Health occurs in the workplace.
CLINICAL MEDICINE PUBLIC HEALTH
Primary focus on individual Primary focus on population Ex: Some occupations confer specific risks,
such as the prevalence of black lung in coal
Test individual patients one- Monitor and diagnose the miners.
by-one health concerns of entire
communities Occupational Health
Emphasis on diagnosis and Emphasis on prevention and
treatment health promotion for the
Promotion and maintenance of the highest
whole community degree of physical, mental, and social well-
being of workers in all occupations by
Emphasis on providing Emphasis on prevention and
medical care health promotion for the preventing departures from health,
whole community controlling risks and adaptation of work to
people, and people to their jobs
Lines of specialization Lines of specialization
organized, for example by: organized, for example by: The goal is to foster a safe work
Organ system Analytical method environment.
(cardiology) (epidemiology)
It may also protect co-workers, family
Patient group Setting and
members, employers, customers, suppliers,
(pediatrics) population
Etiology, (occupational nearby communities, and other members of
pathophysiology health) the public who are impacted by the
(oncology, Substantive health workplace environment.
infectious disease) problem (nutrition) Identification and assessment of the risks
Technical skill Skills in
from health hazards in the workplace
(radiology) assessment, policy
development, and Advising on planning and organization of
assurance work and working practices, including the
design of work-places, and on the
evaluation, choice and maintenance of
Family Medicine equipment and on substances used at work.
Providing advice, information, training and
Specialty that provides comprehensive and
education, on occupational health, safety
ongoing medical care to all members of the
and hygiene and on and protective
family unit.
equipment.
Diagnosis and treatment of general medical
Surveillance of workers' health in relation to
concerns for children, adolescents, and
work.
adults; provides health care regardless of
o i.e. burns, mutilated hands or limbs
age or sex while placing emphasis on the
as an occupational hazard
family unit.
Contributing to occupational rehabilitation.
The specialty integrates biological, clinical,
Organizing first aid and emergency
and behavioral sciences.
treatment.
Provides primary care.
Some also care for hospitalized patients, do The Concept of Community
minor surgery and/or obstetrics.

TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO, 1 of 7

AIANNE REYES,
SUBTRANSHEAD: RJ BELTRAN
 Community Medicine
Lecture #1: Leadership and Professionalism
From a sociological perspective, refers to a
group of people united by at least one
common characteristic
o geography, shared interests, values,
experiences, or traditions.
Community Medicine
Branch of medicine; new specialty
Requires special knowledge of epidemiology,
organization and evaluation of medical care, and
the medical aspects of health service
administration.
Distinct from Public Health
Interest is centered in the community as a whole
and the groups of which communities are
composed
Comprises those doctors who try to measure the
needs of the population, both sick and well, who
plan and administer services to meet those
needs, and those who are engaged in research
and teaching in the field.
Through inter-disciplinary and inter-sectoral
partnerships, the Community Medicine specialist
measures the health needs of populations and
develops strategies for improving health and
well-being, through health promotion, disease
prevention and health protection.
Public Health
The science and art of: disease prevention,
prolonging life, and promoting health and
well-being.
Done through organized community effort
for the: control of communicable infections,
Sanitation of the environment, organization
of medical and nursing services for the early
diagnosis and prevention of disease.
Education of the individual in personal
health.
The development of the social machinery to
assure everyone a standard of living
adequate for the maintenance or
improvement of health.
The difference between Community
Medicine and Public Health lies on the
provider of the health-related service or
medicine. Health services offered at any
levels, from national to barangay is Public
Health. Community Medicine is delivered
and provided by people who specialize in
community medicine.
TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO,
AIANNE REYES,
SUBTRANSHEAD: RJ BELTRAN
EVALS # 1
Preventive Medicine
Is the part of medicine engaged with
preventing to disease rather than curing it.
New Definition: The specialty that focuses
on health in order to protect, promote and
maintain health, and prevent disease,
disability and premature death.
For both infectious disease and chronic
disease.
Understanding and reducing the risks of
disease, death, and disability
LEVELS OF PREVENTION:
o Primary prevention (often
operationalized in health promotion
activities) refers to the avoidance of
disease occurrence as well as actions
taken before disease onset.
Ex: immunizations, water
fluoridation
o Secondary prevention refers to the
early diagnosis (detection) and
prompt treatment of disease and the
avoidance of disability.
Ex: hypertension, cholesterol
screening, programs that encourage
self-assessment for cancers.
o Tertiary prevention refers to the
limitation or reduction of disability,
when disease has already occurred,
through rehabilitation designed to
encourage recovery and prevent
further problems.
Ex: cardiac rehabilitation programs,
occupational therapy for individuals
with a variety of physical disabilities.
Environmental Health
Comprises those aspects of human health,
including quality of life, that are determined by
physical, chemical, biological, social, and
psychosocial processes in the environment.
Theory and practice of assessing, correcting,
controlling, and preventing those factors in the
environment that can potentially affect
adversely the health of present and future
generations. (WHO, 1993)
2 of 7
 Community Medicine
Lecture #1: Leadership and Professionalism
Includes both the direct pathological effects of
chemicals, radiation and some biological
agents, and the effects (often indirect) on
health and wellbeing of the broad physical,
psychological, social and aesthetic environment
which includes housing, urban development,
land use and transport.
2. LEADERSHIP
LEADERSHIP
is creating and making happen what wouldnt
otherwise happen.
getting significant new things done. (I&DeA,
2003)
is the process of influencing others to
understand and agree about what needs to be
done and how it can be done effectively, and the
process of facilitating individual and collective
efforts to accomplish the shared objectives.
(Yukl, 2002: 7)
an effective leader is a person who does the
following:
o Creates an inspiring vision of the
future.
o Motivates and inspires people to
engage with that vision.
o Manages delivery of the vision.
o Coaches and builds a team, so that it
is more effective at achieving the
vision.
Management: is the effective handling of
complex situations and demands to deliver
what should be happening.
TEAMWORK
Figure I. The Key Elements of Effective Leadership
Lewins Leadership Styles
1. Autocratic Leaders
TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO,
AIANNE REYES,
SUBTRANSHEAD: RJ BELTRAN
EVALS # 1
make decisions without consulting
their team members, even if their
input would be useful.
appropriate when you need to make
decisions quickly, when there's no
need for team input, and when team
agreement isn't necessary for a
successful outcome.
can be demoralizing, and it can lead
to high levels of absenteeism and
staff turnover.
2. Democratic Leaders
make the final decisions, but they
include team members in the
decision-making process.
encourage creativity, and people are
often highly engaged in projects and
decisions.
team members tend to have high job
satisfaction and high productivity.
not always an effective style to use
when you need to make a quick
decision.
3. Laissez-faire Leaders
give their team members a lot of
freedom in how they do their work,
and how they set their deadlines.
provide support with resources and
advice if needed, but otherwise they
don't get involved.
can lead to high job satisfaction, but
it can be damaging if team members
don't manage their time well, or if
they don't have the knowledge,
skills, or self motivation to do their
work effectively.
3. TEAMWORK
Creates synergy; the sum is greater than the
parts.
Supports a more empowered way of
working, removing constraints which may
prevent someone doing their job properly.
Promotes flatter and leaner structures, with
less hierarchy.
3 of 7
 Community Medicine EVALS # 1
Lecture #1: Leadership and Professionalism

Encourages multi-disciplinary work where ROLES IN A GROUP

teams cut across organizational divides.
A. POSITIVE ROLES
Fosters flexibility and responsiveness,
especially the ability to respond to change.
Initiator-Coordinator: Suggests new ideas or
Pleases customers who like working with
new ways of looking at the problem.
good teams (sometimes the customer may
Elaborator: Builds on ideas and provides
be part of the team).
examples.
Promotes the sense of achievement, equity
Coordinator: Brings ideas, information, and
and camaraderie, essential for a motivated
suggestions together.
workplace.
Evaluator-Critic: Evaluates ideas and
When managed properly, teamwork is a provides constructive criticism.
better way to work! Recorder: Records ideas, examples,
GROUP PATTERNS suggestions, and critiques.

Table II. Group Patterns B. NEGATIVE ROLES

STAGES ACTIVITIES
Forming Members come together,
Dominator: Dominates discussion, not
learn about each other,
and determine the allowing others to take their turn.
purpose of the group. Recognition Seeker: Relates discussion to
Storming Members engage in more their accomplishments, seeks attention.
direct communication
Special-Interest: Pleader relates discussion
and get to know each
other. Conflicts between to special interest or personal agenda.
group members will often Blocker: Blocks attempts at consensus
arise during this stage. consistently.
Norming Members establish
Joker or Clown: Seeks attention through
spoken or unspoken
rules about how they humor and distracts group members.
communicate and work.
Status, rank and roles in 4. PROFESSIONALISM
the group are PROFESSION: vocation or calling,
established.
especially one involving a degree of skill,
Performing Members fulfill their
purpose and reach their learning or science; a trade or occupation
goal. pursued for higher motives, to a proper
Adjourning Members leave the standard.
group.
Table IV. Professional vs. Amateur
PROFESSIONAL AMATEUR
THE LIFE CYCLE OF MEMBER ROLES -Someone who earns a -Someone who might
living from their trade do the same or a similar
Table III. The Life Cycle of Member Roles or occupation. thing, but without
remuneration
-Professional -Amateurish
performance is one performance is the
which is good, polished opposite however
and of a high quality. much or little payment
might have been
received.

Different Aspects of Professionalism Project

Professionalism (ABIM, 2001)

1) Altruism: giving priority to patient interests

rather than self-interests.

TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO, 4 of 7

AIANNE REYES,
SUBTRANSHEAD: RJ BELTRAN
 Community Medicine
Lecture #1: Leadership and Professionalism
2) Accountability: being answerable to
patients, society and profession.
3) Excellence: conscientious effort to perform
beyond ordinary expectation, and
commitment to life-long learning.
4) Duty: free acceptance of commitment to
service i.e. undergoing inconvenience to
achieve a high standard of patient care.
5) Honor and integrity: being fair, truthful,
straightforward, and keeping to ones work.
6) Respect for other: respect for patients and
families, colleagues, other healthcare
professionals and students and trainees.
Characteristics of a Professional
TRUST
o creates the foundation stone of the
doctorpatient relationship.
EXPERTISE
o A professional person is expected to
have a particular set of skills in their
chosen field, at a level that can be
considered expert.
o acquired through learning,
knowledge, training and practice of
the relevant skills and, in most cases.
o demonstrated by qualifications or
accreditation of some kind.
STANDARDS
o A professional person is expected to
have the ability and dedication to
achieving a set of standards in their
duties that their peers find
acceptable.
RESPECTABILITY
o Expectations that a professional will
work and behave in a manner that is
appropriate to the nature of their
particular profession.
o In medicine, these expectations are
unique:
good standards of personal
appearance and dress
appropriate standards of
speech and personal conduct
such attributes will confirm
TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO,
AIANNE REYES,
SUBTRANSHEAD: RJ BELTRAN
EVALS # 1
to a patient an acceptable
standard of respectability.
RESPONSIBILITY AND RELIABILITY
o Honoring commitments and keeping
promises.
o Ensuring that tasks and duties are
completed and addressed, by taking
the initiative and leading by example
o a lack of immediate attention to your
duties can be the difference between
life and death.
PROBITY
o Latin for good, honest and upright.
o fair, law-abiding and of general good
character.
CONDUCT
o correct behavior and conduct of a
medical professional.
RESPECT
o Respect for authority and the rule of
law.
o aim to be courteous and should at
the very least respect the rights,
dignity and autonomy of others.
HONESTY AND INTEGRITY
o Define how any professional person
should act: being upstanding and
law-abiding, and respectful of the
trust placed in you by others.
o Especially important in the following
situations:
Writing your CV
Preparing medical reports
Record-keeping medical
records should be
contemporaneous and not
retrospectively altered in the
event of a complaint or claim
Any other documents or
forms you are asked to sign or
complete they must be
comprehensive and include
all relevant information
Giving evidence or acting as a
witness as well as being
5 of 7
 Community Medicine EVALS # 1
Lecture #1: Leadership and Professionalism

truthful when giving a spoken

or written statement, you Role Modeling
Bed Side Teaching
must be honest about the Simulated Patients
limitations of your knowledge Small Group Discussions
and competence
Research

SOCIAL RESPONSIBILITY
o must possess a strong sense of
empathy, a desire to do good and
this can be broadly described as
having a social responsibility.
o This might include:
Compassion for those
suffering pain and hardship
A proper and responsible role Figure II. Unique Elements from the Different Focus Groups
in society
A responsible attitude to the What are traits that can contribute to the
environment (especially in success of a team?
relation to the management Honesty/integrity
of clinical and hazardous Selflessness
waste, the use of energy and Dependability
raw materials) Enthusiasm
Good employment practices Responsibility
(in the case of self-employed Cooperativeness
GPs or doctors working in Initiative
private practice) Patience
An awareness of social issues Resourcefulness
where the medical profession Punctuality
is in a position to play an Tolerance/Sensitivity
important or central role (eg, Perseverance
physical abuse in all its forms,
discrimination, etc) ROLES AND RESPONSIBILITIES IN A GROUP
Team Leader
Humanity in both
professional and personal Team Recorder
matters (eg, proving Team Quality Advisor
assistance in an emergency Team Member
situation, a Good Samaritan
For a team to be successful, the following
act)
characteristics are needed:
Adherence to the law (eg, in
A clear direction that is understood
relation to substance abuse,
by all team members
driving while unfit to do so).
Team players
How can We Assess Professionalism? Understood and accepted
accountability measures.
Peer Evaluation
Patient Surveys 5. UNPROFESSIONAL BEHAVIORS
Staff evaluations
Professionalism Portfolio (self evaluation)
Professional integrity is a precious
How can We Teach Professionalism? attribute that needs to be cultivated

TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO, 6 of 7

AIANNE REYES,
SUBTRANSHEAD: RJ BELTRAN
 Community Medicine
Lecture #1: Leadership and Professionalism
and protected from the very start of
a professional career, including entry
to medical school.
Examples of Unprofessional Behaviors Classroom
Setting-Students/Trainee
Arriving for class late and/or leaving early
Being unprepared for group sessions
Not completing assigned tasks
Disrupting class sessions
Failing to attend scheduled class sessions
Examples of Unprofessional Behaviors Classroom
Setting-Students/Trainee
Cheating on an exam
Using Mobile Phone during class
Chatting during class
Focusing on the test vs. learning
Prejudging content in advance
Intolerance of the opinions of others
Examples of Unprofessional Behaviors Classroom
Setting-Faculty
Plagiarism
Judgmental attitude or favoritism
Coming late
Sloppy handouts and syllabi
Abusive behavior
Using Mobile Phone during class
Examples of Unprofessional Behaviors: Clinical Setting-
Students
Dressing inappropriately
Avoiding work and/or responsibilities
Exhibiting little empathy for patients
Demonstrating lack of sensitivity to patients
cultural backgrounds
Not protecting patient confidentiality
Examples of Unprofessional Behaviors: Clinical Setting:
Faculty
Showing favoritism
Failing to attend scheduled sessions
Using inappropriate language or behavior
Asking learners to perform personal tasks, for
example, picking up laundry
Marketing for a new drug
Conflicts between government vs private
commitments
In medicine, some examples of unprofessional behavior
may include:
Treating patients when not fit to do so
TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO,
AIANNE REYES,
SUBTRANSHEAD: RJ BELTRAN
EVALS # 1
Agreeing to undertake a procedure for which
the person lacks the necessary training,
expertise or competence
Being resistant to feedback or maintaining
ones continuing professional development
Laziness, sloppiness or a lack of attention to
detail.
Signs and Symptoms Project Professionalism (ABIM,
2001)
1) Abuse of power: abuse while interacting
with patients and colleagues; bias and sexual
harassment; and breach of confidentiality.
2) Arrogance: offensive display of superiority
and self-importance.
3) Greed: when money becomes the driving
force.
4) Misrepresentation:
o Lying: consciously failing to tell the
truth
o Fraud: conscious misrepresentation
of material fact with the intent to
mislead.
5) Impairment: any disability that may prevent
the physician from discharging his/her
duties.
6) Lack of conscientiousness: failure to fulfill
responsibilities.
7) Conflicts in interests: self-promotion/
advertising or unethical collaboration with
industry; acceptance of gifts; and misuse of
services overcharging, inappropriate
treatment or prolonging contact with
patients.
Reference:
Dr. C. Hipols lecture and ppt.
Recordings
#NoToAlay
Dont be afraid, for I am with you. Dont be
discouraged, for I am your God. I will strengthen
you and help you. I will hold you up with my
victorious right hand. (Isaiah 41:10)
7 of 7
TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO, 8 of 7
AIANNE REYES,
SUBTRANSHEAD: RJ BELTRAN
TRANSCRIBERS: MARK ANTONIO, JIANNE CARLOS, GAB LACORTE, LORENZO MANICIO, 9 of 7
AIANNE REYES,
SUBTRANSHEAD: RJ BELTRAN