Trust Me, I’m a Doctor!
Back when I was in medical school, I had a bumper sticker on my car that said, “Trust me, I’m a Doctor!” In fact, the bumper sticker was false advertising, because I was still a student and not a doctor … yet. The bumper sticker was designed to impress the general public rather than alleviate apprehensive patients. If you Google “Trust me I’m a Doctor,” you’ll find bumper stickers, t-shirts, coffee mugs, neck ties, fridge magnets, cufflinks, and BBQ aprons in seven different languages: “Confia en mi, yo soy un médico.” You won’t find much about the role of trust as the kingpin of medical ethics and professionalism.
What does it really mean to trust your doctor or nurse or any healthcare professional? I looked for the definition of the word “trust” in half a dozen medical ethics textbooks and discovered that the majority of written references relate to the relevance of trust to “patient confidentiality.” Most patients trust that their healthcare providers will keep their medical information private and confidential. Although a vital element of the professional relationship, this is a weak form of trust because it is ultimately guaranteed by law and the Health Insurance Portability and Accountability Act (HIPAA). Patients expect doctors and health professionals to obey the rule of the law.
Now, imagine a patient in a hospital smock, surrounded by strangers in white coats, poking and probing, ordering tests, writing prescriptions, performing surgery, and demanding compliance. This requires another kind of trust, one that is based on moral principle. Stephen Covey (1932 – 2012) described the moral principle of trust as the glue of life (which is not to be confused with the glue on a bumper sticker). Covey says trust is “the most essential ingredient in effective communication. It’s the foundational principle that holds all relationships together.”1 It is odd that this moral principle, which is simply described by Covey as smart business, is not fully appreciated by the big business of healthcare.
Trust is essential to patients because illness makes them extremely vulnerable, and out of necessity, they are literally surrendering their bodies to the knowledge and skills of healthcare professionals. Considering the current emphasis contemporary health professionals place on respecting patient autonomy, no patient should have to second-guess the caregiver’s competence or motivation for a particular treatment plan. Society places a tremendous amount of trust in the fiduciary responsibility of health professionals and the assumption that health professionals will always put their patients’ interests above their own.
Future patients and health professionals are all heir to the trust that has been established by past relationships and clinical experiences. Every doctor, nurse, allied health specialist, medical technician, clerk, and housekeeper is duty bound to honor that unwritten pact and behave in ways that prove they are deserving of continued trust. Trust isn’t earned by t-shirts and bumper stickers, but by behaving as health professionals - professional, from the latin professio, “to make a public promise”- promising to put patient interests above self-interest. Affirming the social contract by building trust is the primary fiduciary duty health professionals have to their patients.
- "Stephen Covey." BrainyQuote.com. Xplore Inc, 2014. 10 December 2014. http://www.brainyquote.com/quotes/quotes/s/stephencov450798.html
Holub P. Trust Me, I’m a Doctor!. The Internet Journal of Allied Health Sciences and Practice. 2015 Jan 01;13(1), Article 3.