Trust

Front page in the Calgary Herald today “Who can you Trust”? I noted that firemen were first, followed by nurses, farmers, doctors, and teachers in that order. The report stated that order hadn’t changed in the last four years, but I do remember many years ago the order was more like “doctors, nurses, teachers, firemen, and policemen”. What happened that doctors are now in fourth place?
Well, for one thing maybe they have been hanging out with politicians too much in the past ten to fifteen years. After all, politicians are in last place garnering only a ten percent trust vote in Quebec. What’s the expression? “Judge people by the company they keep”.
And as a group we certainly have been cozying up to the politicians. Our parent body, the CMA even went so far as to fire an excellent editor of their journal because he wished to publish something that may have been politically sensitive.
Then of course we have been paid by the politicians (government) for the last thirty six years, so perhaps an element of distrust may creep in when a group you should trust is being paid by a group you don’t trust. And when did we start referring to our patients as clients? Isn’t this a term used by lawyers to refer to the people they represent and aren’t lawyers WAY down there in the trust category? And when did we become mealy mouthed and not be up front with our patients and the community at large? Weasel words like “wait times” are actually “risk times” and the people should know it for what it is----but then that would put pressure on governments to DO something about it, and that would make things difficult for the least trusted politicians, and maybe they wouldn’t agree to give us a pay increase. Actually, come to think of it, I’m surprised we are still in fourth place.
Oh yes, and we don’t tell people what they should do anymore. We are educators and our job is to just “present the information and let the patient (client) make up their own mind”. Can you imagine a firefighter yelling to the person on the third floor of a burning building: “you could jump and we will do our best to catch you and position our nets accordingly, or , we could attempt to place a ladder and have a “person” carry you down, or, we could try to send someone up the stairs to get you, or you could wrap yourself in wet blankets, or, etc, etc” along with all the pros and cons of each course of action. My guess is the firefighter would determine the safest course of action and state categorically what the person should do. Have we as a profession lost our leadership ability of giving the appropriate advice and accepting the responsibility for doing so? Are we just another politically correct crowd? I guess perhaps we have and are. We are a “member of a team”, not a doctor but a “health care provider” looking after “clients”, not patients.
Patients should rightly be asking themselves how we, as their advocates, have allowed things to get to this state. Why hasn’t there been “fire alarms, carbon monoxide alarms, and smoke alarms” clanging daily in our health care system over the last twenty years? How did we get from Ben Casey, Dr. Kildaire and Dr. Welby, television physicians who were decisive, compassionate advocates for their patients, to the hormone impaired physicians in the television show “Grey’s Anatomy”?
I must admit, if I was in a burning building and the fireman (person) yelled jump, I would probably trust the advice and do it. But how many physicians even give advice nowadays other than the predigested politically correct “lifestyles” and “options” copout. How many are trusted enough to be asked “Doc what would you do?” and I can assure you, rarely would you, the patient, be provided with an answer to that question and the reasons for it, in today’s medicine. We have sterilized our approach to our patients and made it impersonal. People trust those that are open, honest, forthright, and have proven themselves as trustworthy. Can we as physicians claim those characteristics today and over the past twenty years?