Lately I’ve been thinking a lot about the responsibility of doctors to act as leaders in their communities. Part of this inspired my last post – ‘Do you wish you were Dr Incognito?’. I’d like to follow on by reflecting on what kind of responsibility doctors have to act as role models for healthcare.
There are a bunch of jobs out there in the world where you really need to practice what you preach to have any real credibility. Like the old saying goes, who would trust a skinny chef? Surely the only possible explanation is that the food they prepare is either impossible to force down, or causes violent projectile vomiting when you eventually manage to do so. I was a The Cook and the Chef fan, and Maggie Beer‘s buttery excess would win hands down in my eyes over Simon Bryant‘s more restrained style – Every. Single. Time. (There’s something in the fact that I have somehow managed to turn such a congenial show into some kind of showdown, but I’ll save that for another day)
This logic extends easily. Think about a few others – how much vocational trust would you put in:-
- A morbidly obese personal trainer?
- A footy coach who doesn’t even know the rules?
- An English teacher who has difficulty with spelling?
- A dentist with awful teeth? (starting to get closer to home, aren’t we?)
It’s actually quite a fun thought experiment, matching professions with completely incongruous personal characteristics. (Prizes for the best suggestions mentioned on Twitter with the hashtag #notjustagp or in the comments below!)
But it’s not that simple. At the same time, there’s a grand tradition of people doing things poorly in their personal lives that they’re paid to do all day long. Think about the builder with the eternally unfinished renovation, the mechanic driving the total hunk of junk, the formula 1 driver getting their car impounded (or maybe that’s doing the job perfectly!).
So, where does this place me as a doctor? Do I need to be a picture of good health to have credibility in the eyes of my patients?
Bad-taste patient joke or not, more than once in my so far short career in general practice I’ve heard a variation of the phrase ‘Well, you can’t be a very good doctor if you got sick’. This always makes me shudder – do people SERIOUSLY think that if I’m ever unwell, I can’t be an effective health practitioner for somebody else? After all, being a GP I’m pretty much cannon fodder for nasty colds and violent gastro without even thinking about the more serious risks of infectious diseases like hepatitis C.
But colds aren’t my fault, they’re noble afflictions suffered in my Hippocratic pursuits. So, surely I can gain some kind of ‘Good GP’ exemption for being unlucky enough to contract these kinds of diseases. Perhaps they could even introduce a new Medicare item number for each infectious patient I’m exposed to – danger money, if you will.
So my credibility is safe provided that I don’t catch any ‘self-induced’ diseases.
Although, that year I got influenza after not being vaccinated, well, that was another sacrifice because I was just too busy at work to get the jab. And as I fret about an expanding waistline, I shouldn’t blame myself, but rather the profession that demands so much time, and leaves me so exhausted at the end of the day that I couldn’t possibly do my ‘at least 30 minutes at least 5 times a week’.
So for doctors, as it is for our patients, our own personal health is a complex interplay of personal and societal factors as well as disease factors. Where does the right balance lie? If a doctor is obese, is their advice that a patient should lose weight taken any differently than if they were a normal weight? I’m not sure, but I clearly probably shouldn’t light up a cigarette whilst counselling a patient on smoking cessation. (For the record, I’m a non-smoker – because I wouldn’t want you to assume the alternative and lose professional credibility)
At the end of the day, whilst we can’t avoid being role models, I think the concept is faulty. We’re not there to role model for our patients, but to provide expert advice, guidance and treatment. Our true calling is to inform our patients and guide them to a decision based on their own beliefs and priorities. Or put differently, it matters not what montrosity of adiposity lies beneath our dashing sweater vests, but rather it is the clarity of our thought, and wisdom of our advice, that we should be modelling for our patients.
I’d be delighted to hear your thoughts on how doctor’s personal characteristics and foibles alter the nature of the relationship with their patients.