In the contemporary environment of patient- and value-centered care, it is no longer sufficient to limit the definition of an “excellent radiologist” to someone who is skilled at image interpretation. Since diagnostic radiologists are physicians, they are held to a certain character standard expected of a physician, whose primary objective is to serve the best interest of patients. An “excellent radiologist,” then, is better defined as one who is both skilled at interpreting medical imaging and embodies the attributes of physician character. The concept of physician character can be understood as the interplay between the practice of the care-related virtues, such as empathy, compassion, and kindness, and cooperative efforts with nonradiologist health care team members, termed collaborative professionalism. The very nature of the work of diagnostic radiology, aided by advances in technology, increasingly isolates the radiologist from both patients and other care providers, making it difficult to find opportunities for virtuous care and collaborative professionalism. Using the moral intuitionist model of character development as a conceptual framework, we first delineate the challenges that diagnostic radiologists face in demonstrating virtuous caring and collaborative professionalism. Then, we explore strategies that diagnostic radiologists can employ to overcome these barriers, thereby cultivating their own physician character and setting an example for other radiologists, medical students, and trainees. Finally, we will examine some of the limitations of applying this theoretical model to the real world.
INTRODUCTION
“But tell me, your physician in the precise sense of whom you were just now speaking, is he a money maker, an earner of fees, or a healer of the sick?” - Republic, Book One , Plato
In an evolving health care environment in which all physicians are tasked with providing high quality and patient- and value-centered care, it is no longer sufficient to limit the definition of an “excellent radiologist” to someone who is skilled at catching all manner of radiologic findings and generating a differential diagnosis. As the field of diagnostic radiology struggles to understand what this new mandate requires of its practitioners, it represents not only a challenge but also an opportunity to refine the role of the diagnostic radiologist as a physician primarily in the business of caring for patients . The skill of image interpretation, while critical to that role, must be weighed as a part of the holistic process fundamental to excellent patient care. Accordingly, a discussion of what it means to be an “excellent radiologist” now requires a dialogue regarding a radiologist’s “physician character.” In this article, we explore the barriers to physician character cultivation in diagnostic radiology and, using a “moral intuitionist” theoretical framework for physician character development, propose strategies to overcome these barriers by applying the principles of virtuous caring and collaborative professionalism in daily practice. Finally, we will explore some of the limitations of applying this theoretical model to the real world.
BACKGROUND
Being a physician fundamentally means caring for patients. At the heart of physician character, there is the commitment to act in the best interest of patients while delivering that care, independent of any desire for external validation or to avoid censure. Physician character, in turn, relies on the embodiment of care-related virtues, notably empathy, compassion, and kindness, among others ( ).
The moral intuitionist paradigm of physician character development theorizes that the virtuously moral character of a physician can be cultivated through experiences that activate and amplify intuitive, prosocial instincts that undergird care-related virtues ( , ). For example, encountering a patient in distress automatically activates the caring instinct, a powerful process that occurs beneath the physician’s awareness. This triggering of the caring instinct, in turn, stimulates a cascade of emotional and motivational events leading to a drive to provide comfort. The moral intuitionist paradigm also proposes that systematic exposure to experiences that activate the caring instinct and stimulate virtuous caring behavior contribute to the development of a physician’s character ( ). Consequently, one aspect of physician character cultivation for diagnostic radiologists involves regularly seeking out a range of activities in their daily work, which invoke the caring instinct.
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BARRIERS TO PHYSICIAN CHARACTER DEVELOPMENT IN DIAGNOSTIC RADIOLOGY
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EVERYDAY STRATEGIES TO CULTIVATE PHYSICIAN CHARACTER IN THE DIAGNOSTIC RADIOLOGIST
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PRACTICAL LIMITATIONS TO THE MORAL INTUITIONIST MODEL OF PHYSICIAN CHARACTER DEVELOPMENT
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CONCLUSION
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