Behavioural sciences chapters
Roles of a doctor and desirable attitudes
The many roles a modern doctor plays (healer, communicator, team member, teacher, manager, advocate and more), the attitudes patients and society expect, the basic principles of medical ethics, and how doctors protect their own well-being.
- A modern doctor is a care provider, communicator, team member, decision-maker, manager, health advocate, teacher and learner (scholar) and professional.
- Desirable attitudes include empathy, respect, honesty, compassion, confidentiality, non-judgemental care, reliability and lifelong learning.
- These rest on the four principles of medical ethics: autonomy, beneficence, non-maleficence and justice.
On this page
Overview
A doctor's job is far more than diagnosing and prescribing. Patients and society expect doctors to communicate, work in teams, manage resources, teach, stand up for patients' interests and behave professionally.
Roles of a doctor
WHO "five-star doctor"
Described by Charles Boelen for WHO in the 1990s. The doctor should be a:
- Care provider: gives high-quality, holistic care.
- Decision-maker: chooses tests and treatments wisely, considering cost and evidence.
- Communicator: explains, educates and promotes healthy lifestyles.
- Community leader: understands community health needs and acts on them.
- Manager: works with others, uses resources well, shares information.
CanMEDS framework
Widely used in medical education (Royal College of Physicians and Surgeons of Canada):
| Role | Meaning |
|---|---|
| Medical expert (central role) | Applies medical knowledge and skills |
| Communicator | Builds relationships with patients and families; shares information |
| Collaborator | Works effectively in teams |
| Leader (manager) | Organises care and resources; improves systems |
| Health advocate | Speaks up for patients' and communities' health needs |
| Scholar | Lifelong learning, teaching others, using evidence, research |
| Professional | Ethical practice, accountability, self-care |
Other roles: teacher of patients, students and colleagues; counsellor; researcher.
Desirable attitudes
- Empathy: understanding the patient's feelings and situation from their point of view, and showing that understanding.
- Respect for the patient's dignity, beliefs, culture and decisions.
- Honesty and integrity: truthful information, admitting mistakes.
- Compassion and kindness.
- Confidentiality: protecting the patient's information.
- Non-judgemental care, whatever the patient's background, illness or behaviour.
- Responsibility and reliability: being available, following through.
- Humility and willingness to seek help; teamwork.
- Commitment to lifelong learning.
- Cultural sensitivity.
Empathy = understanding and sharing the patient's perspective. Sympathy = feeling sorry for the patient. Empathy helps the relationship; sympathy can create distance or pity.
Paternalism (the doctor deciding what is best without involving the patient) conflicts with respect for autonomy. Modern practice favours shared decision-making.
Principles of medical ethics
| Principle | Meaning | Example |
|---|---|---|
| Autonomy | Respecting the competent patient's right to decide about their own care | Accepting a competent patient's refusal of surgery after full information |
| Beneficence | Acting in the patient's best interests; doing good | Offering effective treatment |
| Non-maleficence | Do no harm; avoid unnecessary risk | Avoiding unnecessary investigations or drugs |
| Justice | Fairness: equal treatment and fair use of resources | Triage by need, not by wealth or status |
Related duties: truth-telling, confidentiality, informed consent, and avoiding conflicts of interest.
A competent adult who refuses treatment after understanding the risks is exercising autonomy, and the refusal should be respected.
Professionalism
- Putting the patient's interests first.
- Maintaining boundaries (see doctor-patient relationship).
- Punctuality, appearance and respectful behaviour.
- Accountability for one's own actions.
- Following the code of ethics of the Pakistan Medical and Dental Council.
The doctor's own well-being
Doctors, especially house officers, face long hours, heavy workloads, deaths and difficult patients. This can lead to burnout:
- Emotional exhaustion.
- Depersonalisation (cynical, detached attitude to patients).
- Low sense of personal accomplishment.
Burnout increases errors and harms patient care. Protective steps: rest and sleep, peer support, supervision, balanced life, exercise, seeking help early for stress, depression or substance use.
Expect: the roles of a doctor (five-star doctor, CanMEDS), empathy vs sympathy, desirable attitudes, the four principles of medical ethics with scenarios (autonomy in refusal of treatment), paternalism, and the features of burnout.
Quick revision
- Five-star doctor: care provider, decision-maker, communicator, community leader, manager.
- CanMEDS: medical expert, communicator, collaborator, leader, health advocate, scholar, professional.
- Empathy (their perspective) vs sympathy (pity).
- Ethics: autonomy, beneficence, non-maleficence, justice.
- Burnout: exhaustion, depersonalisation, low accomplishment.
Written by The House Job from the Handbook of Behavioural Sciences by Mowadat H Rana (named in the UHS PGET syllabus).
FAQ
What are the roles of the WHO five-star doctor?
Care provider, decision-maker, communicator, community leader and manager.
What is the difference between empathy and sympathy?
Empathy is understanding the patient's feelings from their point of view; sympathy is feeling sorry for them.
What are the four principles of medical ethics?
Autonomy, beneficence, non-maleficence and justice.
What is burnout?
A state of emotional exhaustion, depersonalisation and reduced sense of accomplishment caused by long-term work stress.