The weaponization of professionalism


It’s not every day you see hundreds of doctors flooding Twitter with pictures of themselves in swimwear. The trending hashtag #MedBikini arose when health care professionals began posting in solidarity to demonstrate how maintaining a life outside of the clinic, shockingly, does not detract from one’s merit as a physician. In fact, it makes them more human.

This past week, an article published in the Journal of Vascular Surgery outlined the prevalence of, what the authors deemed to be, “unprofessional” content found on young surgeons’ personal social media pages. The article’s criteria defining what constitutes online professionalism is objectionable.

Criterion defined as “unprofessional” included: “holding/consuming alcohol, inappropriate attire, censored profanity, controversial political or religious comments, and controversial social topics.” Examples included: provocative Halloween costumes, bikinis/swimwear, stances on abortions, gun control, marijuana legalization, and same-sex marriage.

Physicians flooded the Twittersphere with pictures of themselves in bikinis. Doctors posted photos of themselves having a single glass of wine when not working. Discussions continued around how “professionalism” is yet another tool used by the hierarchy to enforce conformity.

All of this spoke to a larger issue in medicine. As medical trainees and physicians, we are acutely aware of the need to trust your doctors and other health care practitioners, especially during a pandemic. Unfortunately, there has been a disturbing trend advanced by some within the medical field to narrowly define what constitutes professional behavior, with increased emphasis on applying these definitions to trainees and prospective trainees.

We are not advocating against professionalism. We take oaths to do no harm and are relentlessly accountable, holding ourselves and our colleagues to exceedingly high standards in the name of patient safety.

However, there remains a harmful movement in medicine, one that uses a flawed idea of professionalism to censor physician’s beliefs, squash individuality, and uphold the antiquated ideas of a physician’s place. Students who use curse words on Twitter are reported to their school; Instagram posts at the beach are registered as unprofessional, and many involved in advocacy work are at risk of receiving cease and desist letters from hospital legal teams.

Would you be uncomfortable to find out that your physician wears a bathing suit when she goes to the beach or has a glass of wine at dinner? Or are you more uncomfortable with the idea that three men spent hours snooping on profiles of their fellow doctors to log this content?

Health care professionals are also patients. When visiting our own physicians, we appreciate their humanity and their honesty. A physician’s humanity is what allows them to form productive and caring therapeutic relationships. However, as hospital systems, lawsuits, and competition have grown unchecked, individuality has been squashed. A doctor’s life outside of medicine is seen only as a liability rather than a strength, especially if they are part of an underrepresented group.

This concerning tone within medicine is a symptom of a broader problem – we expect doctors to achieve some perfect ideal. This ideal is defined historically as a wealthy, white, cishet, abled male. Diverse backgrounds help physicians understand and treat patients better. Doctors with disabilities are able to fix problems for their patients that abled doctors may never identify. Our diversity is so vital that our laws have sought to protect these things from such discrimination in our schools, our training, and in the workplace. However, as in this paper, professionalism is weaponized against minority groups in medicine.

We believe that medicine has its debates too often internally, with trainees and physicians solely contributing to the discussion. This is paternalistic in nature – how should we know what you, the non-medical reader we serve, want?

We write this article to invite a discussion between medicine and our neighbors. Tell us what you think of a physician’s outside life. Tell us how we can best form partnerships with you. Our guess is that you have much bigger things on your mind than whether your doctor goes to a beach on the weekend.

Harry Paul, Tricia Pendergrast, and Wenelia Baghoomian are medical students. Austin A. Barr is an undergraduate student. Ryan Marino is an emergency physician. Chase T. M. Anderson is a psychiatry fellow.

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