Is Professionalism The Opposite Of Character?


Is Professionalism The Opposite Of Character?


Leonard Zwelling

In this short opinion piece in The Wall Street Journal on October 8, former baseball commissioner Fay Vincent discusses his rise in leadership positions spurred on by the guidance of his boarding school headmaster. Toward the end of the piece, Vincent quotes Henry Kissinger that “the essence of leadership is character.” I believe that this is true and that character is a very individual trait of humans. It is often hard to define, but in the end is the ability of the individual to do the right thing even when the right thing is tough to do. The most successful leaders are those who bring the right character to the job at hand at a specific moment in time.

I would like to compare that to the latest fad in academia and academic medicine, professionalism for which there are now courses and institutes. The course used by MD Anderson emanates from Vanderbilt, I understand. It may come as a surprise to the current Anderson leadership, but all problems cannot be solved by external courses or on-line video training. Sometimes, you need a person with life experience to answer the call.

At first, you would think that professionalism and character would go hand in hand, but I don’t think so. Professionalism’s modern iteration is far more the following of sets of rules that dictate behavior rather than following one’s own character and judgment in times of challenge. I would also add that uniformity in behavior is not a trait historically valued in MD Anderson faculty members while character surely is. And MD Anderson has had some amazing characters over its almost 80-year history. In fact, I am going to argue that it was these large, over-sized characters that put MD Anderson on the oncology map and that professionalism’s tamping down of individual character is what will undo all of that work to attain excellence in patient care, research, education, and prevention.

This was on great display on Friday, October 7 when the Senior Faculty Pioneer series hosted Dr. Bernard Levin in a well-attended zoom call when he discussed the origins of the prevention program at Anderson of which he was the original leader, division head, and vice president. It may seem a given now that cancer prevention is an essential part of the MD Anderson mission, but in the early 1990’s it was not and it took the vision of then president Mickey LeMaistre and the politically savvy leadership of Dr. Levin to get prevention off the ground as a nexus of prevention patient care, research and education on a par with those mission areas that had traditionally been the essence of the MD Anderson portfolio.

Being how new this all was then, Dr. Levin did not have a handbook by which to plot a trajectory to excellence. Rather it was his leadership through character that made prevention the reality it is today.

If MD Anderson is to continue its leadership, the next visionary has to feel welcome to be disruptive, to oppose the status quo, and to break a few eggs to make a new kind of omelet. I fear that professionalism will squelch that and that could be the undoing of the institution as we know it.

The current leadership of MD Anderson has no definable vision nor plans for continued excellence. In fact, it’s the administration’s intimidation of out-of-the-box thinking faculty who try to create anew and/or those who preserve the excellence of the old that will only serve to subvert excellence of character and achievement.

It is up to the faculty to insist on a return to individual character as the core of MD Anderson values and fight the move by leadership to rubber stamp behavior and weaponize professionalism as a tool of intimidation.

6 thoughts on “Is Professionalism The Opposite Of Character?”

  1. In collaboration with 2 physician colleagues at BCM & the Center for Professionalism there, we developed a visual model for professionalism— an attempt to make granular the jene se qua of the characteristic, and providing a platform for a swift adoption of an original curriculum. At the center core of professionalism is Trust & Respect, with the outer ring defined by values, expertise & comportment. These all define the critical importance and components, and still offers a bandwidth for individualism.

    I am not certain MDA has a working definition for professionalism? I have taken the Vanderbilt training and it is more of a method to deal with colleagues who are deemed to exhibit “unprofessional” behavior…. starting with a cup of coffee, and subsequent escalating responses when “indicated”. Reports of such behavior may be originated by patients or peers.

    My point is…. without a clear definition / expectation, being held accountable becomes arbitrary / subjective. And, the adoption of an approach that is reactive rather than proactive is not caring or exhibitive of stewardship, let alone fostering of psychological safety.

    Perhaps it would be a consideration for MDA leaders to place less emphasis on classroom trainings by administrators thru the Leadership Institute, offered at times when clinicians are consumed with patient care. Perhaps leaders might consider more emphasis on their own personal behaviors and role modeling, as well as those of outstanding physician colleagues which flood the organization? After all, we ALL want a culture of Trust and Respect.

    1. Leonard Zwelling

      Absolutely and I agree that the leaders ought to walk the walk and not just talk the talk. Perhaps you should convey your excellent observations to the leadership. Len

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