I think what is needed is for professionals to put understanding ‘patient experience’ at the top of their priorities instead of way down below scientific curiosity, technical challenge, data-gathering, efficiency, and whatever else. Doctors are morally reprehensibly ignorant of ‘what it’s like for the patient’ and treat us like livestock in a food processing factory: that means they have lost their humanity, and no amount of “they have such a lot to think about, and if they thought about what it was like for the patient they could not do their job” will excuse it. If you have to sacrifice your humanity to practice as a doctor then there is no such thing as a doctor, only technicians, and in any case it isn’t true, it is a gross moral misunderstanding. If they gave thought to what it is like - if they asked themselves what they would want if it was them, or one of their family - they would treat us very differently - and much better. Especially in terms of preparing us sensitively for the reality to come, and ‘walking by our side’ through it, and being open to ongoing care - care - after it. But they do not think that, they are not trained to, and the exigencies of the job to some extent prevent them though as I say I do not want to make excuses for them. They are decent people, but they are nto thinking the right thoughts and nothing in the training or continuing professional development is asking that of them. It is about training, and it is possible for a doctor to be a human being, and stay a human being while practising as a doctor. It is a question of priorities. How they behave shows what their priorities are, and that shows what sort of person they are. Now I’m not saying they aren’t decent human beings. I’m saying they are complacent.
I also think they are smug about the treatments - they are so proud of their great successes. My experience has led me to the view that the consulting room (the insulting room) is a very particular social situation. The doctors have already decided before they meet us what they’re going to do, and telling us is a formality they want to get through with minimum disruption so they can get on with their ‘real’ work of treating patients; talking to them, informing them so they can truly consent to treatments, is not part of that, it is an obstruction. Further, they want our admiration. They want us to be as impressed by the medical technology as they are, they want our unqualified gratitude, and if they don’t get that, they are so bereft of emotional, intellectual, imaginative and dare I say spiritual resources, that they interpret a patient’s lukewarm response as negativity or even depression. They think they are clever (after all, they’ve been encouraged to think that since getting their A grades and getting into medical school and the rest) and that they are cleverer than other people, who therefore won’t understand. I’m saying, from my own experience, that they place requirements on us, make demands on us, when it should be the other way around - and that patients are too often too eager to meet those requirements obediently, partly because nice people like to please others, partly because patients are dependent on doctors in an unequal relationship. But it’s obviously not conscious or none of us would do it, we’d realize the folly of it.
It is that personal, because ultimately, we suffer, and we suffer at the hands of individuals, who do those things to us - fail to inform, talk down, forget what we need to know, downplay, skew and spin the truth, omit the all-important details, fail to consider how it feels, fail to take an interest except intheir narrow brief - diagnosis, treatment decisions, administer treatment, monitor results, goodbye; those things they do may be necessary (though whether they genuinely are is another question), but the spirit in which they are done to human beings should not be one of blithe indifference - it would be impossible for a person who had genuinely taken the time to consider the consequences for the person of what they do for a living to say to them, “Cured, go and get on with your life.” I have tried and failed to raise this with my hospital, nobody wants to know.
sno