CHAPTER 16
PROFESSIONALISM
A profession is different from an occupation. Your interaction with a professional is different from that with nonprofessionals. A professional has certain privileges, obligations, responsibilities, and risks. A profession has been defined as “a collective of expert service providers who jointly and publicly [are] committed to always give priority to the existential needs and interests of the public they serve above their own and who, in turn, are trusted by the public to do so” [1]. In a more inclusive definition derived from the Oxford English Dictionary and various literature on professionalism, a profession is an occupation whose core element is work based on the mastery of a complex body of knowledge and skills. It is a vocation in which knowledge of some department of science or learning or the practice of an art is used in the service of others. Its members are governed by codes of ethics, and profess a commitment to competence, integrity and morality, altruism, and to the promotion of the public good within their domain. These commitments form the basis of a social contract between a profession and society, which in turn grants the profession a monopoly over the use of its knowledge base, the right to considerable autonomy in practice, and the privilege of self-regulation. Professions and their members are accountable to those served and to society. Hence, there is a social contract between the professional and the people he or she serves. Dentists have special knowledge and skills by being able to diagnose and treat illness and disease. Dentists possess special privileges to ask private questions, to prescribe medications, and to perform surgery. Dentists also have special responsibilities of self-regulation and to put the patient’s welfare first. Therefore, dentistry is a profession fulfilling the above definitions. Hence, a professional dentist will not capitalize on the vulnerability of patients in an attempt to maximize his or her own interests and will live up to the trust that the public and every patient places in him or her and in dentistry as a whole. The public trust must be sustained if the profession will continue under a social contract.
There are nine categories of professional obligation:
1. The chief client: This is the person or set of persons whose well-being the profession and its members are chiefly committed to serving.
2. The ideal relationship between dentist and patient: The relationship should bring certain values to the client, values that cannot be achieved for the client without the expertise of the professional.
3. The central values of the dental professional: A profession is focused only on certain aspects of the well-being of its clients.
4. Competence: Every professional is obligated both to acquire and to maintain the expertise needed to undertake his or her professional tasks (this can also be seen in the 10 elements of the standard of care in Chapter 13).
5. Sacrifice and the relative priority of the patient’s well-being: A profession obligates its members to accept significant sacrifices that are neither unlimited nor unqualified.
6. Ideal relationship between co-professionals: Professionals should work together as collaborators for the patient’s well-being.
7. The relationship between dentistry and the larger community: Professionals are obliged to also collaborate with those other than patients and co-professionals, such as dental hygienists and office staff, and those outside direct patient care but who have an interest in the well-being of the patient, such as pharmacists, physicians, nurses, and dental manufacturers/suppliers.
8. Availability of services: Professionals will attempt to serve all of society, including those with special needs and those who do not have access to adequate dental care, through charity and public dental health programs.
9. Integrity and education: A professional not only works by a set of ethical values but also lives by them [2].
These nine obligations required of dentistry in order for it to be a profession may also be condensed and presented in a set of three inquiries:
1. Who serves?
2. What kind of service is provided?
3. Who is served? [3]
A profession must ensure that its members are competent to serve the public. Dentistry has set up specific schools of dentistry and a set of benchmark tests (state boards/regional boards/residencies) to create a standard for the competency of dentists. Not anyone may become a dentist, even if tutored by another licensed dentist. Without graduating from a dental school and passing a d/>