I was recently at a professional development event where respected NASA engineer Dr. James Brown enthusiastically advised attendees to “Plagiarize often and without shame!”. He admonished his audience to consider, when attempting to come up with an idea, whether one might in fact be the only human being in the history of human beings to come up with this idea, and that if tempted to think you are, well, then, check with the other human beings first. His message was that creativity can be overrated, and sometimes building upon what is already available, even copying and improving, can be the best path forward.
In the spirit of that message, I am devoting this post to the consideration of someone else’s blog. This morning I read this post, by Scottish doctor Malcolm Kendrick, in which he characterizes modern medicine and its relationship with patients as a conspiracy of the willing. I think we do want to believe that we will be protected from harm if we do this or that thing, take this pill, or follow these instructions. Dr. Kendrick compares this to ancient religions, in which people appealed to religious leaders and deities to protect them, suggesting science just came along and gave us some explanations, but didn’t really change the underlying social need to be protected from unforeseen harm.
I have written in the past about evaluating credibility of medical information and advice found online, in order to avoid the quacks and shills that will try to prey on your fear for profit. This is an important skill set for anyone who wants to step outside of the medical establishment and search for his or her own health information. However, professionals within the medical establishment who are dogmatic in approach and unwilling to open their minds and practice up to a model of cooperative patient care are, in my opinion, also dangerous to our health. Malcolm Kendrick calls to task a system, mutually supported by doctor and patient, in which we are all afraid or unable to ask “could I be wrong here”?
As patients, we are faced with trying to navigate a healthcare system that demands active participation. We must be able to ask questions of our healthcare providers, make sure we understand treatments and treatment options, advocate for our loved ones in care, and even often take an active role in providing actual care during a hospital stay. We often have to coordinate communications and information between different specialists, and with pharmacists or physical therapists. We cannot afford to be passive.
In the face of this reality, I have still often been met with defensive reactions from within the healthcare system. For example, last year I asked to see my husband’s chart after a surgery, because I suspected we were being sent home with the wrong prescriptions; in this case, I was right. Another patient’s chart was being used in the discharge process. I wondered what would happen if he was on his own, 8 hours after surgery, and just took what they gave him and left. I’ve also written in the past about steps you can take to help you in navigating “the system”. Time and again, in my personal experience, assertiveness in approach has been proven to be the best, and maybe only, way to navigate.
If quality of care and outcomes are to improve, if I am willing to pull my weight in these efforts, I must be met with openness in healthcare professionals to entertain cooperative models, to listen to me if I’ve done my own research. The overarching principal still must be to “first do no harm”, but if I come to the table with a well-researched addition to my healthcare plan that does not pose substantial risk or harm, I believe that my healthcare team should be open to it. So many people try things on their own, or add strategies to treatments, and never inform their doctors, because they don’t believe they will be supported. Or because they did try to talk about their ideas, or what they read online, and their doctors were not open to it. How can we blame people for paying for time from a naturopath or homeopath who is willing to listen to them and support them, if their mainstream healthcare team is not? We must remember that harm comes in many forms, most frightening when a patient is rejecting proven treatment in favour of something unsupported by evidence, but there are also subtle harms in offering false hope or draining financial resources, that could be avoided in an engaged and cooperative healthcare system.
Take home message for today – if we want patients to listen to sound, scientific medical advice, we need a system that is willing to listen to patients as well, and is not afraid to say “I don’t know”, or “I was wrong”.
Image credit: Creative Commons, file name 10_03_001335a, Boston Public Library, no restrictions on use.