The front page of today's Toronto Star featured a headline that read: "Medical Secrets: When Honesty is the Policy". It then went on to explore how often this policy is not in effect and its tragic results. Approximately 23,750 people die each year in Canada as a result of adverse events in hospital. In the US the number is even higher, estimated at 98,000. Something is seriously wrong with our medical system!
Far too often I believe we are quick to hold the doctors and surgeons accountable for these startling statistics. In truth, they are only statistics until they touch our lives directly and then they become our nightmare. As with many of the social challenges we face, this one is a complex and multi-headed beast and I don't presume to have the answers, only some swirling thoughts.
One aspect of this issue that seems to be over looked is the physician's themselves. It is tempting to point our collective finger at them as they seem so untouchable. When society isn't hailing them as gods, we are quick to vilify them instead. The fall is indeed a steep one. And what we seem to miss is their very real humanity.
Admittedly, I have been on the sidelines as I am not a physician, but I have worked with enough clerks through fellows as well as established GPs and surgeons to appreciate that their training is both exacting and brutal at times. It is rife with humiliation at the hands of their peers and superiors. It embeds a message they must be experts and that they must at all costs be correct or bear the serious consequences of their errors.
Given the degree of en-culturation they endure, it takes a very mature and self-realized physician to have the courage to admit an error in their judgement and wear their own humanity openly. Undoubtedly the stakes are high when dealing in human lives but do we ever stop to question what the stakes are in their personal lives?
We, as consumers of health care have been far to complacent. We are content to rely on perceived expertise of a third party. We fail to take responsibility at all times for our own well-being. We have been content to elevate our physician's to god-like status for as long as it suits us. We aren't likely to perceive our dentist or our accountant in quite the same light. It is one thing to respect a professional's field of expertise and quite another to engage in groundless reverence. We are contributing to the problem with our expectations and unquestioning engagement with social identities. Can we see the person behind the mask? How do we expect to be seen in return?
Perhaps we need to turn our attention to the notion of identity. There is personal identity - the aspect that represents the essence of who we truly are at our very core as a unique individual. There is also the far more familiar social identity that is cultivated through our upbringing, education and belief systems. Our social identity is rarely one of our own making but rather represents a composite of the many rules and expectations we have acquired on our journey through life. It is this social identity that invites careful examination if we are ever going to close the gap between the humanity of patient and physician. As long as a gap exists, we will continue to hold physicians to impossible standards and physicians will struggle to free themselves from the tight little boxes that leave little room for compassion, authenticity and honesty. Without authenticity there is precious little room for the safety that honesty requires.
By design, our health care system in Canada bombards physician's with unbelievable workloads. Reeling at the sheer volume of patients passing through their hands makes the convenience of pharmaceuticals seem like an easy answer to the congestion of busy family practices. In those frenzied 10 minutes, how much human interaction can take place?
Canada is a democracy and we, as health consumers have the right to demand more from our government when it comes to health care. We also must be willing to consider that more comes with a price tag. Another multi-headed beast is a multi-tier system but its beyond the scope of today's musings.
Let me turn instead to an even deeper conversation that lies below all of this and that is the worldview that embraces the fundamental concepts that we are not experts when it comes to our own bodies, that our bodies are something to to normalized at best and feared at worst, that there is no underlying intelligence in our body responses and that Descartes has had the final say when over 200 hundred years ago, in his opinion, the body was a mechanistic device.
Dehumanization of patient and physician isn't such a big leap from there, is it?
There is another way to look at the world that is autopoiesis. And that my friends will be another entry so stay tuned!
Far too often I believe we are quick to hold the doctors and surgeons accountable for these startling statistics. In truth, they are only statistics until they touch our lives directly and then they become our nightmare. As with many of the social challenges we face, this one is a complex and multi-headed beast and I don't presume to have the answers, only some swirling thoughts.
One aspect of this issue that seems to be over looked is the physician's themselves. It is tempting to point our collective finger at them as they seem so untouchable. When society isn't hailing them as gods, we are quick to vilify them instead. The fall is indeed a steep one. And what we seem to miss is their very real humanity.
Admittedly, I have been on the sidelines as I am not a physician, but I have worked with enough clerks through fellows as well as established GPs and surgeons to appreciate that their training is both exacting and brutal at times. It is rife with humiliation at the hands of their peers and superiors. It embeds a message they must be experts and that they must at all costs be correct or bear the serious consequences of their errors.
Given the degree of en-culturation they endure, it takes a very mature and self-realized physician to have the courage to admit an error in their judgement and wear their own humanity openly. Undoubtedly the stakes are high when dealing in human lives but do we ever stop to question what the stakes are in their personal lives?
We, as consumers of health care have been far to complacent. We are content to rely on perceived expertise of a third party. We fail to take responsibility at all times for our own well-being. We have been content to elevate our physician's to god-like status for as long as it suits us. We aren't likely to perceive our dentist or our accountant in quite the same light. It is one thing to respect a professional's field of expertise and quite another to engage in groundless reverence. We are contributing to the problem with our expectations and unquestioning engagement with social identities. Can we see the person behind the mask? How do we expect to be seen in return?
Perhaps we need to turn our attention to the notion of identity. There is personal identity - the aspect that represents the essence of who we truly are at our very core as a unique individual. There is also the far more familiar social identity that is cultivated through our upbringing, education and belief systems. Our social identity is rarely one of our own making but rather represents a composite of the many rules and expectations we have acquired on our journey through life. It is this social identity that invites careful examination if we are ever going to close the gap between the humanity of patient and physician. As long as a gap exists, we will continue to hold physicians to impossible standards and physicians will struggle to free themselves from the tight little boxes that leave little room for compassion, authenticity and honesty. Without authenticity there is precious little room for the safety that honesty requires.
By design, our health care system in Canada bombards physician's with unbelievable workloads. Reeling at the sheer volume of patients passing through their hands makes the convenience of pharmaceuticals seem like an easy answer to the congestion of busy family practices. In those frenzied 10 minutes, how much human interaction can take place?
Canada is a democracy and we, as health consumers have the right to demand more from our government when it comes to health care. We also must be willing to consider that more comes with a price tag. Another multi-headed beast is a multi-tier system but its beyond the scope of today's musings.
Let me turn instead to an even deeper conversation that lies below all of this and that is the worldview that embraces the fundamental concepts that we are not experts when it comes to our own bodies, that our bodies are something to to normalized at best and feared at worst, that there is no underlying intelligence in our body responses and that Descartes has had the final say when over 200 hundred years ago, in his opinion, the body was a mechanistic device.
Dehumanization of patient and physician isn't such a big leap from there, is it?
There is another way to look at the world that is autopoiesis. And that my friends will be another entry so stay tuned!
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