The easiest way to offend a patient is to fail to engage with their reality by projecting our assumptions, theories and realities upon them. – Brian Bloom. Meaningful Disease.
There’s an awful lot of arrogance around these days. So many people seem to assume they are the sole possessors of The Truth. In my own sphere of work, I frequently read pontifications from non-clinical “scientists” berating doctors and patients. The arrogance usually takes the form of a fairly abusive attack on anybody who claims a benefit from a therapy which the “scientist” doesn’t support. It’s a “Trust me I’m an expert” at best, and it’s “Just be quiet, I know better than you” at worst. Arrogance is never appealing.
My view is that a good scientist is a humble scientist and never claims to possess The Truth, never claims to know all that needs to be known about any subject.
A good doctor puts the patient first. As Brian Bloom says in the quotation at the beginning of this post, projecting their own assumptions or theories onto the patient is a failure to engage. A failure to engage is a failure to practice good medicine.
The balance of power has started to shift in the doctor-patient relationship. I’m glad. It’s time doctors cared about every patient they meet, put the patients’ agendas to the fore, and it’s time for us to reject one-size-fits-all treatments which actually never ever have fitted everyone.
Heroes Not Zombies 
Well said, ‘The Truth’ is only a significant statistic, the real truth is what a patient feels.
I’ve read brief accounts from doctors and pharmacists who got irritated by being shot down for not toeing the party line. And to think this is what happens to people who’s careers depend on constant revision and assessment!
It’s all about sales in the end. If you can sell x to x amount of people, who cares about the rest? Tragic.
Ah yes you always have to be wary of bearers of “The Truth”!
For clinicians, the final arbiter of the success or otherwise of any treatment HAS to be the patient. Whose life is it anyway?
Dr. Bob,
I had commented on a prior entry and then lost your blog. I found it again, after hunting through numerous pages of comments, so if it is okay with you, I would like to ask permission to put you on my blogroll. Don’t want to lose you again!
Doctor this is a very good entry. One size fits all treatment is the main reason why thyroid disease is made so much more difficult than it should be to treat. In my previous comment, I spoke to you of my doctor from Amsterdam and my utmost respect for him. He was the first doctor who looked at me and said the words that changed my outlook on doctors and how I need to stand up for my rights:
“I can not tell you how you feel…”
When he spoke those words, and intertwined them with reflexes and blood pressure, I knew there was hope for me and at that point in my life, I never thought there could be again.
I understand that medicine is not an exact science, but just the lack of ‘arrogance’ can assist a patient in gaining respect for the physician and also learning to trust physicians when they have been scorched before.
Thank you for posting!
Harlequin