Diligence and Integrity—Hallmarks of the PA and NP Profession

October 4, 2022   |   Healthcare Professional

It is apparent to me that I am stuck on diligence for yet another month. I cannot escape it because it is the core of healthcare professionals who care for the sick each day. I call it a hallmark because it is supposed to be imprinted or sealed in the minds and hearts of all in our profession. The Oxford Dictionary defines diligence as careful and persistent work or effort. It lists three kinds: ordinary, extraordinary, and, interestingly, slight. Diligence is the antithesis of negligence, which incidentally is the reason for most litigations against healthcare providers. Some believe that diligence is the mother of good luck, yet, it has nothing to do with luck in the arena of patient care. It is an intentional internal decision that translates into an active approach to our patients.

Integrity is a member of the same family; it is defined as the quality of being honest and having strong moral principles, moral uprightness, soundness, and firm adherence to a code. We have all taken the Hippocratic Oath, and it should be more than a ceremony but a way of life. Integrity is the state of being complete or undivided, and a lack of integrity becomes tragic in the life of a medical caregiver.

For many of us, we developed these two attributes during our academic preparation. We had to sacrifice something of ourselves. E.E. Cummings said, “It takes courage to grow up and turn out to be who you really are.” I guess it is a part of our metamorphosis as we enter this wonderful field of healthcare. We must possess diligence and integrity if we are to be complete. An old periodical, Poor Richard’s Almanac, states that “A small leak will sink a great ship,” and so it is for the professional who does not commit to integrity every day.

I take great pride in those whom I have met on my forty-seven-year journey in medicine. I can never forget the lasting effect of one of my mentors, Dr. Walter Loch, M.D., a former chief of otolaryngology at Johns Hopkins Hospital. As a very young PA, I innocently inquired of Dr. Loch: “When was the last time you performed a perfect operation?” I asked this because of his tireless effort to achieve perfection and his complete humility. His reply, “Bob, I have never performed a perfect operation, and when I do, it is time for me to retire because there is something wrong with my standards.” This should be the epitaph of all of us in our respective specialties. For those of you who are in agreement, I refer you to the words of John Steinbeck: “I am compelled, not to speak like a grateful and apologetic mouse, but to roar like a lion out of pride in my profession.” I share that same pride in what we endeavor to accomplish on our mutual journey in medicine.

Sadly, sometimes even though we have employed these two virtues in our practices, we are confronted with failure. Our best attempts in patient care will sometimes fail, and internally we struggle with this in the same manner in which our patient struggles. They are angry and disappointed and seek revenge, whereas we are disillusioned and are tempted to quit. We have failed, and yet we have tried so hard. Zig Ziglar said, “Failure is an event, not a person. Yesterday ended last night.” To which Elon Musk adds, “If things are not failing—you are not innovating enough.” Failure in our chosen field of medicine can and will often reveal itself as a lawsuit. Lawsuits are painful and discouraging, which is why you need to do two things, take two actions:

  • Remember the last two quotes in this missive. They will encourage you and give you strength.
  • Find the most acceptable A.A. Best++ Superior-rated malpractice company. Many years ago, before changing to my new company, I was met in the conference room for a deposition by an attorney who was visibly drunk and smelled of his lunchtime martinis and who had forgotten to bring my charts I fired him on the spot and notified those present that my defense was unacceptable and I would return with new representation. It was then that I found the company where I have purchased my malpractice insurance for almost thirty years. “When something goes to hell, the people who stand by you without flinching—they are your family” Jim Butcher, author. That same company became like family to me as they are family owned and share my commitment to diligence and integrity.

I will see you next month and hope that you take this missive to heart.

Written For CM&F By: Robert M. Blumm, PA, DFAAPA, PA-C Emeritus
CM&F Clinical Advisor

Photo by Tima Miroshnichenko


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