If we’re generally bad at holding service providers accountable for good service, we’re totally useless when it comes to dealing with providers in the healthcare sector. We’ve no one to blame but ourselves when we end up in abusive relationships with healthcare professionals.
Mostly, it’s because we don’t take charge of our healthcare, abdicating all responsibility for our own wellbeing to the medical professional, the hospital authority, the medical aid scheme which foots some or all of the bills for our treatment. We’ll attribute authority and responsibility to anybody but ourselves.
We’ve systematically disempowered ourselves – or, at the very least, allowed others to take the power from us, the right and responsibility we hold, to make informed decisions about our health.
Part of the difficulty might be the way medical professionals – not all, but a good few – too often arrogate to themselves God-like status.
Popular culture has been awash with this understanding of the medical profession, best illustrated in the crime thriller movie, Malice, when doctor character Jed Hill (played by Alec Baldwin) testifies in a medical malpractice case about how people pray to God that their relative will come through a medical procedure. “You ask me if I have a God complex? Let me tell you something: I am God.”
Lest you think I’m being unnecessarily nasty and unappreciative of doctors, especially given the almost lifelong benefits I have received from the collective clinical skills of the medical profession, consider this:
In doctor-patient encounters, patients’ psycho-social state – let alone their expectations – are mostly ignored; there is seldom effective communication about the diagnosis and treatment plans; doctors take decisions all the time without properly hearing their patients and, certainly in the private sector, without anything approaching peer review or even peer consultation.
Even the patient’s questions – though they might reflect a shallow dive into the practitioner’s worst enemy, “Dr Google” – are not given reasonable attention.
Against the fallacy of doctors as gods or at least as basking in “self-satisfied superiority to others”, is the enduring idea propagated more than a hundred years ago by North American physician William Osler, that doctors must not only express their own human-ness, but recognise the humanity of the patients they treat.
“The good physician treats the disease,” he wrote. “The great physician treats the patient who has the disease.”
In one of his last pieces of writing, pioneering heart transplant surgeon Christiaan Barnard reflects on the failure of modern medicine:
“Health is far too serious a matter to be left solely in the hands of the health professionals,” he notes, adding that the personnel in the massive hospital complexes “provide a disease service rather than a health service; instead of promoting health, they try to displace the disease.”*
Of course doctors must bring their generalised knowledge of a condition but, following Osler, a one-size-fits-all approach to treatment is usually not the best one.
I’m happy to note that some universities now consciously seek to disabuse medical trainees of the behaviours that encourage this perception of a God complex or (should we say) – God delusion. There is almost universal acknowledgement that young doctors must learn from their patients, must learn how to communicate with their patients (and their relatives!), how to listen, how to be humane in their approaches, how to express real personal interest in the individual, how to be empathetic.
We need to know we can trust not only our doctors’ technical skills, but also their personalities, their “people” skills, their willingness to develop a rapport with us, see us as an individual rather than just another part of a collective disease, their inclination to be persuaded to explore a different treatment (and possibly even a different diagnosis entirely).
But if healthcare is about OUR health, then we need to be much more willing to engage with doctors than we generally do. We need to take back the right, the obligation – and the power that flows therefrom – to be responsible for informed decisions about our healthcare.