Defining the core competency of professionalism based on the patient's perception

Background: To better define professionalism using a 10-question multiple-choice survey of patient preferences. Methods: One hundred and ninety-one adult patients (response rate: 52% +/- 5%) completed a survey over a 3-week period in resident and faculty ophthalmology clinics in a university setting in a rural portion of the southern USA. Most patients voluntarily provided information on gender, race and age. Data are reported at proportions +/- 95% confidence intervals. Results: Patients desire a degree of formality from their physicians in the form of a handshake (61% +/- 7%), greeting of family members (69% +/- 7%) and in addressing oneself as doctor. They also prefer note taking by the physician while speaking with them. However, patients do not think that the wearing of a white coat is necessary. Most patients assume (84% +/- 5%) that the physician washes his/her hands. Surprisingly, patients (60% +/- 7%) are willing to maintain a relationship with a physician despite the use of medical jargon. We found few differences related to gender and none related to race. Women (64% +/- 9%) preferred a closed door during the exam. Men (81% +/- 8%) either did not want the physician to wear a white coat or said that it made no difference. Those younger than 46 years (67% +/- 10%) preferred the door closed compared with those who were older (45% +/- 10%). Conclusions: Our study helps to define professionalism by providing concrete examples of the expectations of patients in the southern USA during physician interaction. Minor adjustments to the patient encounter based on these findings may increase patients' perception of professionalism, creating a higher level of trust. These are teachable precepts that can be incorporated into residency training.