The Silence of the Profession

Many of us in Australia will remember an ad for toothpaste in the 1990s where a man (with a great toned and tanned upper torso mind you) has his back to us whilst he is facing the mirror brushing his teeth. We are told they can’t show us his face, because he is a dentist. Apart from learning about this particular brand of toothpaste (?!) we learn from this that medical professionals are not allowed to be seen in public.

For me this is a great adage of the medical profession where there is some strange notion that we should be neither seen nor heard, and this extends to many in the profession who feel constrained to be seen as a person in public, or to have and voice their opinion in public for fear of being hauled before the medical board, or having their reputation as a doctor undermined or destroyed.

Many doctors will not be on social media, have blog sites or websites, and do not want to have themselves in the public eye, lest something ‘go wrong’ and their reputations be destroyed.

But lets consider this.

Does this even make sense?

Why is it that we would feel that being seen as the person that we are would possibly get in the way of people respecting us professionally. And why do we seek so much to separate the two? Are we really such a Jekkyl and Hyde? Are we one person at work and then some strange demonic being in our private lives that we would not want anyone to know about? Surely not…

Most the people I know in medicine are lovely people, ordinary people, just like you and me…. They have families, they have partners, they have children and everything that is entailed with having children, they have health issues, they get sick like everyone else, they are often (if not usually) tired, they have things they enjoy in life, they have their favourite TV shows, (frequently Master Chef…!) and their favourite movies…. They like to travel, go on holidays, get upset or react to the same things in the media as everyone else, buy clothes, wash clothes, do their laundry take out the garbage……in short, doctors are people just like everyone else.

There appears to be this mystique in the profession that you are not allowed to disclose who you really are to your patients, and thus you cannot be seen as who you are in public in case the ‘mask’ is undone and people suddenly step aside and realize in shock ‘hey, you’re a person just like me. I thought you were my doctor who is perfect and now I see you’re just a regular person. I’m not going to see you because you have different opinions on child welfare (or insert other opinion here) to me….’

There is this fear in the profession that if you share what you really think, or how you really feel, that you will be seen as being ‘unprofessional’, that you will lose your business, people won’t trust you any more, colleagues will turn on you, people of particular religions won’t come and see you because your faith does not agree with their faith, people of particular sexual orientations won’t come and see you because your personal opinions do not reflect theirs….. if we reveal our love for the outdoors will those who are bookworms not come and see us? If we reveal our discontent with the current government will we not get jobs or will those of a particular political leaning no longer trust our professional judgment if we are not aligned with their politics?

Can we only express in public things related to our fields of profession to make sure that is the way that ‘we are seen’?

So much of how we are seen is tied up in our mystique of our professional performance and in fact you are taught to be ‘professional’: to keep people at arms length, to not get close with patients (ie people) to not let people get to know too much about you, lest they not trust or respect you any more.

In contrast, I have the found the more that I am me with my patients, the more relaxed they are, the better our relationships are and the better the therapeutic relationship is. Being personable is no barrier to the physician-patient interaction, it enriches it. It builds trust and respect as there is no hiding or pretence.

Yet in medicine, we are taught to hide behind the ‘professional’ mask at all times, even ‘off duty’!

Lets look at this more closely.

People are people and we are all people underneath it all no matter what we do.

So why is it that we feel that we can’t show ourselves to other people as people?

We all know that we are all people, so why hold ourselves as ‘doctors’ to a different standard to other people?

Do we feel that we will be seen to be less authoritative once we are seen to be equally human?

Do we feel that we will be less respected when people know about us as people? Or that people won’t listen to us when they see how we really live?

Given that health care and medicine is about people, it simply does not make sense to consider ourselves less as people, with less rights than other people, simply because we have the tag of ‘doctor’.

Tag someone ‘lawyer’ ‘banker’ ‘cleaner’ ‘student’ ‘celebrity’ and we are still all people underneath it all. We all go through life, have our opinions, issues, loves and cares. We are all the same underneath it all. No-one is better than another.

Is there really a need to seek to hide it, to pretend that we are not human like everyone else, to strive to be seen to be different to everyone else?

Does the role of doctor mean that we can’t participate in public debate or that certain topics are ‘off limits’ whereas they are not for other people?

Does the role of doctor mean that we can’t be publicly seen to have personalities, relationships, likes, dislikes, cares, opinions, senses of humour or perhaps even religious beliefs?

It simply does not make sense.

One of the biggest stresses in life, is pretending to be something you are not, holding yourself in and keeping yourself in. 

We have a crisis of burnout in medicine. The root of burnout is losing who you are, conforming to a ‘role’.

Hiding ourselves or feeling the pressure or the need to be silent and not seen is contributing to our burnout as a profession when everything in us is calling out to speak freely, and to be seen freely and in full for everything that we are.

Many doctors are afraid to not only be seen on social media as a person, but also afraid to voice their opinions about medicine, the health care system, for fear of losing their jobs, their reputations, their livelihoods and if they proffer opinions they are done so on condition of anonymity, particularly if the area is controversial.

And in our collective professional silence, not only are we harming ourselves, but humanity is missing out on our perspectives, insights, wisdom and humour.

Health care is missing out.

We see it all. We have much to bring as people and with our expertise in our professional fields. There is much that is ill in health care and our silence allows it to continue. Humanity including our patients stand to benefit enormously from our free expression.

It is a fundamental human right to have freedom of expression, freedom of thought belief and ideas.

Given that is so, its interesting to ponder then why is it that we as doctors are so cautious in the way that we allow ourselves to be seen and known in public, choosing silence, or anonymity, or even carefully chosen selected ‘safe’ words, rather than expressing ourselves in full in accordance with our full human rights?

As doctors, we’ve been silent throughout the ages. Is it not time to reclaim our fundamental human rights as people, to come out of the silence, and express and express, and express in full?

Advertisements

12 thoughts on “The Silence of the Profession

  1. I just brought this up as a topic of discussion in one of my classes earlier this week! My 8 classmates and I are set to graduate in a matter of weeks and become licensed clinical genetic counsellors. We’ve spent two years in classes and workshops together, countless hours commuting and studying. Yet we all have a sense that we only know a small part of each other’s lives because we’ve only brought the “professional” face to our training. We discussed the fact that this is expected of us in training and in our careers – to be strictly neutral and professional at all times. And then we have this whole other life outside of work that should not mix. We are taught to “compartmentalize” our lives in this way in order to maintain a professional persona, but I’m not sure that compartmentalizing ourselves is actually truly possible. In fact, it seems like trying to do so is detrimental to the fullness we could otherwise be offering patients and colleagues, as you have pointed out here. Thank you for being so candid about a taboo topic!

    Liked by 2 people

    • This is Brilliant thank you For Sharing! I am a student of Nursing and am also taught this, that I should have “professional Boundaries” around patients and not get to know them or them get to know me, but it feels impossible to try and separate these two ‘ares’ in my life as I would be completely faking if I didn’t show my open, caring nature to all patients.

      Liked by 1 person

      • I agree Harrison. Its a physical pain to pretend to be something we are not. What terrible thing might happen if you show your gorgeous tender and caring nature to all people?! I think there is this fear in ‘the profession’ that we will be ‘physically inappropriate’ if we allow ourselves to relax and be caring, or that we will get ‘attached’, but that is not what true caring is so there is no need to fear any of that.

        Liked by 1 person

      • I have recently relocated and so am still building relationships with my new doctors, but I enjoyed a fabulous ‘professional’ relationship with my previous doctor. Originally I shared a piece of my life with her and over the years we each added to our sharing. As my removal date beckoned we would share hugs on parting.

        I used to feel the ‘lucky one’, but reading this I now wonder if she felt the same…?

        I remember saying once how I went to see her for advice in her field as she would for instance see a banker for advice in theirs, or me for mine. We all have different talents, or forms of expression; and together we each contribute something necessary to our communities.

        Any relationship is a two-way street; it can’t be just down to the doctor, the patient would also need to contribute if they could just see that the person in front of them was also a human being, exactly the same as they.

        An equal: contributing their talent as we contribute ours.

        Like

  2. It makes sense what you say – it must be subconsciously quite isolating that Doctors need to keep up the professional role rather than just be a ‘normal’ person in the community – and that when they need to seek help or support, as every human needs to at some stage, it makes it all the more difficult. Coping mechanisms in secret do not usually work. Great insight – thank you.

    Liked by 2 people

  3. It must be a helluva job to live a double life. In my work as a bricklayer people are always talking about the current issues, or whats going on for them in their life, even if you’ve only just met them. So the excuse of “oh I don’t know you that well to talk about this” is blown out of the water. When we seperate our lives into pieces does it really help us, or do we become different people for the different people we meet, never really being the whole person we are. As is so wonderfully said in the last sentence of the article “Is it not time to reclaim our fundamental human rights as people, to come out of the silence, and express and express, and express in full” not just for doctors but us all.

    Liked by 2 people

  4. Fantastic article Dr. Maxine!
    What I realised whilst reading this is how detrimental holding back is for our personal health & wellbeing, but also how the healthcare industry and world are missing out! Complacency & silence feeds the corruption and evil in our industries. What if doctors shared more about themselves, their case studies and medical miracles, what they agree and disagree with in the medical industry from first hand experience – where we need more support…? This might just be part of the answer that the healthcare system needs… A vitality boost – first and foremost from its workers!
    On another note I realised that as a society we have judged doctors to ‘be arrogant, snobby, thinking of themselves as superior, etc.’ apart from the fact that we have double standards: in then wanting them to be perfect, there has also been a misjudgement here, as society has not understood that this reserved behaviour could possibly just be due to holding back, fear, security, and protection to be seen as ‘professional, neutral and innocent’… Exactly what you have spoken about here.
    Thank you for breaking this consciousness about hiding who you are, and bringing it back to ‘people are people, so let’s just be people’.

    Liked by 1 person

  5. Surely we should be all of who we are with everyone we meet – regardless of our ‘professional’ hat. I was married to a doctor for 13 years – and noticed the effect you describe. As a former nurse – who are also looked on as different – as are lawyers, teachers etc. Yet we all have problems; lives to lead, parents to care for and children to raise. Strange how professionals are put on pedestals – do they really want to be there? Under our skin we are all the same under the skin? As you so eloquently express “Is it not time to reclaim our fundamental human rights as people, to come out of the silence, and express and express, and express in full?”

    Liked by 1 person

  6. Maxine this is such a great article and so so true.
    I was pondering on this very topic recently, as one of my friends has just spoken publicly about abortion, and we are seeing her as very courageous, as her job may be on the line and there may be other risks…but why should this be? Why do we not feel free to express our personal opinions and share our personal stories? There is such a pressure on us to not speak out, and we do play it safe and succumb to this by and large, but there is actually a great irresponsibility in this.
    We are very caring responsible members of the community, and if we were to speak up about the evils we see in the world, the world would be a very different place….

    Like

  7. Absolutely awesome article Maxine! The lack of transparency between who we are as people and our professional lives is a huge issue with the way We are taught to be as professionals! It can result in people not giving their full care, not having any joy at work and trying to maintain “two lives” essentially which is doomed to fail. We were made to be transparent, what is the matter if people know where we stand in all things? It certainly doesn’t diminish peoples professional qualifications, but this is the fear that is believed and is taught in medical school, nursing school and other schools etc.

    Liked by 1 person

  8. Pingback: The Silence of the Profession | maggiemoonlight

  9. What a breath of fresh air Dr Maxine… as someone who has enjoyed an open and engaging personable relationship with my doctor for many years, I can attest to the quality of care I feel whenever visiting him. On the odd occasion I have the need to see someone different, it has almost always been a fairly uninspired experience, albeit function and competent without question. The contrast of the two has me fully appreciative of the value in consulting with someone who is prepared to be open and expressive of who they are, and not just deal with me based on a role.

    Like

Leave a Reply

Please log in using one of these methods to post your comment:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s