Altruism Defines the Profession

0716-McEvoy-Rob-Dr-Aug15 3In times of austerity should the medical profession grapple with self interest or should we step up and be leaders?

This editorial caught me preparing for the ninth Doctors Drum, titled “It’s Always the Doctor’s Fault?!”. Would we get an audience full of self-absorbed comment about how doctors get a raw deal? To be fair, one major contentious point is that doctors are often asked to intervene early, when evidence is flimsy and not all in – things will go wrong in these circumstances and they want some slack cut because of it.

0716-Kid-tyre-swin-silhouettePerhaps Doctors Drum would take a wider view of how community desire and restricted resources interact, with doctors unfortunately caught in the middle? Political correctness comes into it too. In this Men’s Health edition, 43% of male doctors, seemingly respected in the community, are wary of displaying public affection to children. And I hear of teachers who are not comforting kids when they hurt themselves in school playgrounds. It seems that media attention around child abuse, plus the focus on men as perpetrators of family abuse and betrayers of vulnerable people, have left many male doctors in ‘no man’s land’.

That expression (‘no man’s land’) comes from early wars, where men would line up and kill each other. They still do, in a less personal and more technologically sophisticated way. Maybe situations like these point to an unhealthy influence from testosterone? This could explain the gender differences evident in our e-Poll results and we surmise, carry over into the medical profession when it comes to bullying or suchlike. Do men need to question their stereotypes of male modelling and get more in touch with their feminine side?

I must admit, I am wary of the men who say they represent the profession. As we head to an election, our professional representatives don’t seem to be standing up for the disenfranchised as doctors used to in the past. It’s just more politics.

It appears the disenfranchised require agencies to produce media releases, to get heard these days. One such media release arrived today which said food insecurity in Australia was reaching crisis level, with Foodbank’s survey showing a quarter of hungry people are regularly going without food. In WA around 53,000 people are assisted each month (22,000 are children) – often from single parent families, the aged, or those with disabilities or a mental illness. The profession stood up for these groups in the past, urging a fair go for all. Now these people are getting lost in a sea of competing interests, while doctors come up with a set of their own demands.

Within days of this edition hitting the streets the election will be over. As resources for health become scarcer, political parties of all persuasions will be more about consumer convenience, user pays, self-help resources, and patient rights. The gap between the ‘haves’ and ‘have nots’ will continue to widen.

We will be thrust on a technology trail and doctor and patient will be pushed further and further apart in the interests of patient autonomy in decision-making – as if Dr Google hasn’t already affected that relationship. And who amongst us will profit most from interventions of convenience?

There are interesting times ahead. The generation of doctors who have known nothing but bulk billing seem more prepared to go with the flow but there are generational differences. In 10 years’ time, will we see a profession that cares more for others or one that cares mainly about itself?