I think a lot of health and medical professionals take themselves too seriously.
When I read through research articles, almost every one ends on a note that goes something like this:
“The referenced study indicates such and such a problem is very serious and warrants closer consideration by medical professionals and public policy people”
It’s become so common place that I think a lot of authors put it in there because a paper might not be taken seriously without it.
You get the impression that the people doing the writing feel like it’s their obligation to take care of the helpless peasants that are afflicted with one thing or another. But I have doubts that their perception is shared by the afflicted.
For instance, The Wall Street Journal has an interesting article about pharmaceutical sales in Japan:
What persuades doctors and patients to use a particular drug, it turns out, is local.
In the U.S., doctors tend to focus on a new drug’s clinical trial results–the medicine’s safety and effectiveness. But doctors in Japan often have other interests, too, particularly the biology behind a new therapy’s development, industry officials say.
Japanese physicians also want to know how it performed specifically in Japanese patients. “That’s a significant hurdle upfront, because they’re hungry for evidence,” says Tony Alvarez, Merck’s Japan chief.
However, the need for doctors to understand the truth about their medicine is not passed onto their patients. Medical paternalism is a strong cultural ethos in Japan.
Reading more about the Japanese led me to this curious bit about doctors attitudes towards cancer disclosures:
Despite the increasing concerns of truth disclosure, most cancer patients are not told the truth about their disease in Japan…….
Results showed that 72% of patients and 83% of clients wanted to be told the truth, but only 33% and 34% of them thought that the truth should be told to cancer patients. These attitudes of patients and clients regarding truth disclosure were more positive than those of the general public and health care workers in previous studies. At present, 13% of doctors inform cancer patients of their disease. These trends indicate that the Japanese attitude toward avoiding truth disclosure stems primarily from paternalism but is also influenced by social characteristics including insufficient understanding of this issue.
However, the doctors might want to give their patients a little more credit. In another survey, 85% of patients said they’d want an active or collaborative role in the decision making process for illness:
The overall proportions of respondents who preferred active, collaborative, and passive roles were 12%, 71%, and 17%, respectively……
Our study suggested that a majority of Japanese patients have positive attitudes towards participation in medical decision making if they are fully informed. Physicians will give greater patient satisfaction if they respond to the desire of patients for participation in decision-making.
Admittedly, these preferences were not as strong for cancer. However, the same overall point was true. And other evidence suggests there are pervasive mismatches in preferred information sharing.
This result is not unique to Japan. In America there are also large discrepancies between what doctors think their patients ought to know and what cancer patients want to know:
Across all cancer types, patients wanted more participation than what actually occurred. Research to date documents a pervasive mismatch between patients’ preferred and actual roles during decision making.
At Nutrition Unplugged, there was a discussion about how dieticians should fight the war on obesity. One of the participants in the debate framed the issue like this:
We’ve lost the war on obesity. Fighting fat hasn’t made the fat go away. And being thinner, even if we knew how to successfully accomplish it, will not necessarily make us healthier or happier. The war on obesity has taken its toll.
Do fat people view the issue the same way? How many of these people “fighting the war” are obese themselves?
I don’t want to throw sand on the motives of the people doing the talking, but I sometimes think framing the issue this way makes things worse. Our obsession with diets and weight loss causes anxiety and confusion over what we eat. Maybe the expressed paternalism by health professionals distorts the layperson’ decision making as well.