How Plastic Surgeons Value Professionalism: Using Q Methodology to Explore the Prioritization of Professionalism

Background: Medicine is no longer limited to the treatment of diseases - the use of plastic surgical techniques as a commodity to improve the appearance of healthy people has become a trend, and plastic surgeons who invest in the market of cosmetic medicine have quickly gained considerable benefits. Will the transformation of the role of plastic surgeons from aesthetic restoration to commercial embellishment damage the creation and maintenance of their sense of professionalism? Objectives: The purpose of this study was to determine, by utilizing Q methodology, which aspects of professionalism plastic surgeons value. Methods: Q methodology is a mixed research method employed to study subjectivity through factor analysis. This study analyzes a rank-ordering of participants' level of agreement with a set of subjective statements related to a given topic. Q statements were developed on the basis of a literature review, expert panels, and medical organizations' codes of conduct. After face and construct validity checks, as well as a pilot test, we interviewed 31 attending plastic surgeons. Data were collected from April to May 2017. Results: This study concluded that the main types of medical professionalism held by the respondents can be represented in 4 factors: (1) mastery of clinical skills, (2) leadership and management, (3) knowledge sharing, and (4) multifaceted. Conclusions: Respondents in this study highly emphasized surgical skill and sought to maintain good relationships with their patients based on their settings. Although they were reluctant to place community service as a top priority, our respondents tended to emphasize the healer aspect over commercialization.