A Thoughtful Article on Unprofessional Behaviours

A recent article in BMJ Quality and Safety cites evidence that unprofessional behaviour is associated with (and likely causal of) unsafe practice.[1] This is an intriguing finding from a number of studies and has verisimilitude. These are not experimental studies and so cause and effect remains unproven. Nevertheless, there are good theoretical reasons for accepting a cause and effect explanation. In any case, it is good to exhibit professional behaviour, net of any technical association.

As to how to improve ‘professionalism’, that is a more complex matter. I think it would be very hard to select for this attribute, but I also suspect that cognitive ability and great role models are important in generating this, and other types of, desired behaviour.

— Richard Lilford, CLAHRC WM Director


  1. Wong BM & Ginsburg S. Speaking up against unsafe unprofessional behaviours: the difficulty in knowing when and how. BMJ Qual Saf. 2017; 26: 859-62.

One thought on “A Thoughtful Article on Unprofessional Behaviours”

  1. Yes very little evidence on improving professional behaviours. Quite a lot on improving clinical behaviours and practice: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1487455/

    Is part of the problem that all behaviours are viewed through a clinical lens and therefore justified?

    I also challenge the idea that cognitive ability is a factor. Many leadership studies show no consequential link at all to intellect and cognition. It is more about an ability to be reflexive, a willingness to learn, and an ability to temper one’s ego in relation to knowledge (acknowledging there is something to learn).

    Normative re-educative programmes have been shown to make a difference to behaviours per se. Are professional behaviours a different kettle of fish? Henry Mintzberg suggests there is no allegiance to the institution – only to one’s profession – so this may be an issue in terms of accountability to others.

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