Wednesday, June 15, 2011

Professional Narcissism

My best friend and I were discussing professional narcissism the other day, because he'd run into some with a mental health counselor. We mutually agreed this professional got one more try to show why his opinion was correct. But if it was just dogged denial without reason, my friend would bounce. I told him of the fail-safe phrase that exists in the field of psychology: "I just don't feel comfortable working with this therapist."

It's a non-shaming, non-blaming escape hatch. And it exists for therapists too: if they don't feel comfortable working with a client, or don't think they can handle a particular issue, they can just pass. They'll find someone else to work with the individual, but they'd not duty bound to treat everyone that enters their office.

And my friend understood more of what I deal with as, sure, I've become a patient-expert on my own case. But my body is weird. Most doctors are going to have to return to the books to understand what's going on with me. That can be really intimidating, not to mention time consuming. But doctors are obligates, even if they're out of their depth. That's not fair to anyone.

It's a lose-lose situation, the doctor admits they're overwhelmed and it's a mark of weakness. And then there's the old joke, "You want a second opinion? Okay, you're ugly too." It's a personal affront to doctors if you call their judgment into question. Our schools train doctors this way, and our society teaches patients to believe the same: MD means 'Minor Diety'. But that traps doctors in a situation where they have to defend their answers even when they suspect or know they're wrong. It's called 'saving face'. And we've seen how absurd disasters can get when this value comes into play: look at Fukashima.

Aren't we sophisticated enough to give up this fairy tale of 'the all-knowing doctor'? We have documentaries on medical mysteries all over the place. We know for a fact these people are human, just like us. Can we add a little fairness for everyone's sake and allow doctors to get patients to the appropriate match in the first place? What's wrong with a little humility and honesty? (If you're a trial lawyer, I don't wanna hear it. You work on commission.)

Perhaps I'm just na├»ve. Is it insurance liability that drives this nightmare? Are there other economic forces at work?  I do not know enough about the industry to know.

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