Professionalism in the Practice of Osteopathic Medicine
Core concepts
Professionalism is fiduciary: put patient interests first, maintain boundaries, be honest, and protect confidentiality. Know capacity versus competence: clinicians determine decision-making capacity; courts determine competence. Informed consent requires capacity, disclosure, understanding, and voluntariness. Disclose medical errors promptly and honestly, apologize, explain, and document. Manage conflicts of interest, gifts, and social media use; do not post identifiers. Know mandated reporting, obligations when a colleague is impaired, and advance directives. Traps include breaching confidentiality unnecessarily, overriding a capacitated patient’s refusal, accepting inappropriate gifts, and covering up errors. Professional behavior also includes academic integrity, respectful team communication, and appropriate use of supervision. When unsure, ask an ethics consultant or supervisor and document the reasoning. A useful question is whether you would be comfortable if the action were publicly reviewed. Confidentiality may be breached only when required or permitted by law, such as certain communicable diseases or imminent harm.
Worked example
A competent patient refuses a recommended biopsy. Confirm understanding, explore concerns, and document refusal; do not coerce. Rule of thumb: autonomy wins when capacity is intact, even if the clinician disagrees.