The biggest mistake is not learning from one…

A friend recently asked me why I am so hard on doctors. “You write a lot of negative stuff about us,”  he said.

That worries me. I am not a nihilist. I believe in what we do. I put doctoring decidedly in the noble category, right alongside teachers.

In fact, my attachment to doctoring is the reason I write about it.

Here’s my thinking about confronting negative stuff: One of the major problems with healthcare at this moment is an erosion of trust in doctors. We have a credibility problem.

The information age has changed the landscape of medicine in two major ways: First, access to health information is no longer restricted to and controlled by caregivers. Second, and perhaps more important, is that the imperfections of doctoring, including our human nature, are exposed for all to see. Social media is like sunlight in that way.

But mistakes aren’t the reason we are losing trust. People know the practice of medicine is far from an exact science. In my experience, patients are forgiving when confronted with candor and honesty. Some of my best patient relationships are with those who had complications from my actions.

The trust problem comes when we don’t acknowledge our mistakes. It makes us look like we aren’t learning from them.

These are the thoughts I had when reading the Selling of Attention Deficit Disorder story on the front page of the Sunday edition of the NY Times. This scandal is about the overuse of psych meds in children, but the overall narrative isn’t specific to Pediatrics.

At the root of these ADHD-type of missteps is that doctors were lazy in the interpretation of science. We let the pharmaceutical companies and thought leaders shape the message. Skepticism requires strength. But sometimes we are weak: Rather than insist that the overweight sedentary man with high blood pressure exercise more and eat less, we prescribe pills. And then to whitewash, we pretend the pills are a substitute. Some doctors go so far awry as to think it’s their fault patients don’t take care of themselves–that doctors actually control health.

These are all big mistakes.

Our avoidance and denial of them erode the public trust. And without credibility, how can we expect people to believe us when we recommend clinically useful treatments? Like vaccines, statins and early palliative care for advanced lung cancer. for instance.

This is why I believe that we must, as a profession, look inward and confront our flaws, our humanness. Mistakes teach the most. Let’s show the public that we are learning from them.

JMM