I believe physicians have the moral obligation to make diagnoses based on science and evidence. My experience, however, is that far too many physicians make diagnoses based on feelings and unexamined biases against a backdrop of science and evidence.
In 1999 I became very ill. It was the start of a journey that would take me through the often incapable hands of many medical professionals and ultimately result in damage to my brain. I sought the help of professionals to heal the wounds my mind had sustained from childhood trauma. In addition I had undiagnosed auditory processing disorder and premenstrual dysphoric disorder that went ignored despite years of complaints. 16 years later, I am beyond the childhood trauma but disabled as a result of iatrogenic brain injury.
I learned during my healthcare journey that the most deadly epidemic patients in the United States face isn’t heart disease, cancer, or obesity. The most deadly epidemic is health care employee ego. The second most deadly epidemic is bias among health care providers that prevents them from systematically applying logic when problem solving.
While this blog is inspired by my disastrous journey in search of appropriate diagnosis and treatment; it will also address other contemporary issues in medical and health care administration ethics that are relevant to everyone who ever sets foot in a doctor’s office, hospital, or clinic.
These writings will discuss neglect, abuse, and trauma. These writings will discuss mental illness. These writings will discuss prejudice and assumptions. These writings will discuss surviving all of these things and moving forward to try to heal a system so sick that it can take a cold and turn it into pneumonia. A system that can take anxiety and turn it into crippling panic; a system that can kill when it is supposed to cure.
In my journey I have discovered that there is a huge divide in expectation between medical consumers and medical professionals. Public health agencies, and even some health systems wisely recommend that patients ask questions and become informed about their health. An informed consumer can make healthy choices. Sadly, many physicians aren’t interested in the type of dialogue that promotes understanding. Too many physicians are interested solely in a monologue the offers the patient only tiny bits of information the doctor deems most important. Physicians often underestimate or overestimate a patient’s potential for understanding. A true dialogue rarely takes place during a doctor’s visit. Sometimes this is because of time constraints, but more often it is due to ego constraints.
Excessive self-confidence interferes with genuine inquiry and responsible exercise of logical investigation.
If the arrogance, ego, and irrationality endemic in healthcare culture continues to grow unchecked, no attempts at building a healthier society will be successful. The consequences reach far beyond the individual patient. They extend to the patient’s family, the patient’s employer, health insurance companies, social service agencies, welfare and safety net programs, local and national economies, and society at large. If a sick patient can’t get well because of how they are treated when they seek help, everyone suffers.