The distance physicians create between patients and themselves due to regulations intended to protect patient rights lessens their character, and the competitive nature of medical school and residencies doesn’t help either. That is, according to the paper philosophy professor Saba Fatima recently presented at a medical conference.
Fatima makes that argument in her paper, “The Character of a Physician,” which she presented last month at the Western Michigan University Medical Humanities Conference.
“My main thesis was that the way that the profession exists right now, physicians cannot have good character and that the very rules that are set up to protect patients’ rights harm the development or harm the kind of character that a physician ought to have,” Fatima said. “So my recommendation then was that we need to examine the doctor’s character independent of the goals of the profession… and independent of the effect on patient and patient care.”
The rules and regulations that protect patients’ rights do not relate to a physician’s character, and Fatima said she is not arguing to get rid of those regulations because they exist for a reason.
Physicians had “a lot of paternalistic attitudes” in the ’70s and ’80s, according to Fatima, which led to the restrictions on physicians from sharing patient information. Despite the necessity of those laws, Fatima said they have caused physicians to become “disinvested.”
“The patient is sort of left, oftentimes, psychologically alone to make our decisions,” Fatima said. “There’s not an affective bond between the physician and the patient anymore, and the physician then goes by a checklist.”
Fatima said she is worried about the distance between physicians and patients because that job is supposed to be “a labor of love.”
“This is not similar to the job of a soldier where you expect the burnout, where you expect the character to be damaged after a war…,” Fatima said. “This profession has all the markers of being a virtuous profession, but the physician is not virtuous anymore. The physician is disconnected, is burned out emotionally, psychologically.”
Once a physician’s character can be examined independently, then Fatima said it is acceptable to look at what physicians can do to “sustain themselves” and have good character. Some medical schools, according to Fatima, have “narrative medicine,” in which physicians come together and talk about their work.
“It has nothing to do with good patient care… but it’s more for the development of the physicians themselves because nowadays, [physicians are told] don’t cry in front of the patient, because that’s unprofessional behavior,” Fatima said. “You have to be a professional, but you’re a human being. If you clamp down on all your emotions, it’s going to be very hard to sustain a good character through the length of your career.”
Studying the physician’s character is important, according to Fatima, because without investigating it, there will be “massive burnout” of physicians, specifically in primary care.
“Primary care is overworked. Primary care physicians end up seeing 22, 23, 25 patients a day…,” Fatima said.
Though she was concerned about reaction from doctors she presented to, Fatima said her paper was “received very well.”
“I got a lot of good feedback from physicians who talked about the kind of impediment that they face in thinking about themselves, part of which is doctors are supposed to be superhuman. Their job is to cure other people and not to lament about their own depression or their own burnout or their own sort of apathy toward their job…,” Fatima said.
Other comments focused on how unrealistic Fatima’s research could be when applied to a physician’s practice, noting that a high number of patients needs to be seen per day to run a financially stable practice and in doing so, physicians “cannot realistically have affective bonds with all of [their] patients, otherwise [they’re] going to be distraught all of the time.”
“That was a very valuable insight for me to have about [that] ‘OK, this cannot just be a theoretical paper. It has to be applicable to the everyday lives of physicians, something that they can implement in non-ideal, clinical settings and that’s always a good perspective to have…”
Fatima said she hopes to submit her paper to academic journals for publication within the current academic year.
Filed Under: Philosophy