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Are medical doctors arrogant?

From Wikiversity

Disclaimer: This debate is so far based on anecdotal evidence. It should be taken with a pinch of salt.

Medical doctors are arrogant

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  • Pro This is borne out by Quora testimonies[1][2] Inconclusive, though.
  • Pro The physicist Richard Feynman relates how arrogant and unthoughtful medical personnel misdiagnosed his girlfriend Arlene and how they attacked a visiting medical doctor who was asking questions that were on the right track. Inconclusive, though. A quotation: 'The doctor was there, so I asked him how the Wydell test came out—it was an absolute test for typhoid fever that involved checking for bacteria in the feces. He said, “It was negative.” “What? How can that be!” I said. “Why all these gowns, when you can’t even find the bacteria in an experiment? Maybe she doesn’t have typhoid fever!” The result of that was that the doctor talked to Arlene’s parents, who told me not to interfere. “After all, he’s the doctor. You’re only her fiancé.” I’ve found out since that such people don’t know what they’re doing, and get insulted when you make some suggestion or criticism. I realize that now, but I wish I had been much stronger then and told her parents that the doctor was an idiot—which he was—and didn’t know what he was doing. But as it was, her parents were in charge of it. Anyway, after a little while, Arlene got better, apparently: the swelling went down and the fever went away.'[3] One can continue reading the passages from the link, in which Feynman relates how the doctors proposed to lie to Arlene about the diagnosis.
  • Pro The philosopher Karl Popper says something along the following lines. Concerning the present I am an optimist. Admittedly, some things should be improved. For instance, medical doctors treat patients who approach their health rationally, that is, critically, as if they were imbecilles. Exact quotation and tracing to a source missing. Inconclusive, though.
  • Pro Studying medicine requires memorizing/rote learning rather than genuine intelligence and capacity to understand. Very intelligent people are often not so good at rote learning.
    • Objection This does not prove that medical doctors are arrogant; they might as well reflect on the above and be humble as a result.
    • Objection If the above is true, it should be possible to measure in some way, and demonstrate a correlation between being a medical doctor and having a reduced capacity to understand. A formal demonstration was not delivered.
  • Pro It is easy to be arrogant when the well-being, life and death of the patients often depends on the skill and good-will of the doctor. The doctor can relatively easily do something bad to the patient but not the other way around. Medical misconduct is easier than taking the one doing it to the court and proving it.
    • Objection That may sound plausible on the face of it but requires a rigorous proof and analysis.
  • Pro The arrogant character of Dr. House (from an American television series) points to a common perception that (too many?) medical doctors are arrogant. And that common perception is likely based on patient experience. Inconclusive, though.
  • Pro Arrogance among medical doctors is common per Berger 2002.[4]
  • Con No formal proof of the motion was provided so the motion should be dismissed as unsubstantiated.
  • Con As per Marion Stuart: "Someone who has done the hard work and has gone into medicine because they care about people, and are interested in helping peoples' lives and making the world a better place, is not going to be arrogant."[5]
    • Objection That assumes without a proof that most medical doctors are in the field in order to help patients rather than e.g. enter a well-paid, respected and powerful profession or enjoy the power of manipulating human bodies.
    • Objection The above is a non-sequitur: someone who sincerely primarily wants to help people can still be arrogant. The very idea of "I am saving lives with the help of extensive medical knowledge (requiring learning of a large medical vocabulary) and you are not" plausibly leads to arrogance.
  • Con "Arrogant" can be widely interpreted, so needs a more precise definition. Especially: Is arrogance assumed to be unwarranted confidence, or just unusual confidence, or just a displeasing personality trait? Is it culturally relative?
    • Objection Arrogance in medicine can be defined as a first approximation using the examples by Feynman and Popper above. Thus, a doctor is arrogant if he behaves as if he was infallible, as if the patient was stupid, incapable of thinking together about the diagnosis and treatment (including asking meaningful questions), incapable of understanding the medical literature and medical statistics or unable to meaningfully put things being said by the doctor (who is in fact fallible) to doubt.
  • Con Arrogance, even some of its more precisely defined interpretations, may be unmeasurable. (This may mean that a more tractable question is "Do people perceive doctors as arrogant?" This may be more important anyway, since the reframing could lend itself to ways to correct for undesirable outcomes. Solutions could include training doctors in communication without making them feel judged and defensive -- or helping the public to understand what their doctors are saying.)
    • Objection The problem raised by this debate is not a patient perception but lather lack of humility/presence of arrogance in some (or too many?) medical doctors, all too likely leading to avoidable mistakes. The question raised by this debate is important in so far as it can lead to adapted patient and family behavior such as: become aware of possible arrogance of people who often know much less than they think; seek a second truly independent opinion from an expert if you can afford it; in case of doubt or presence of warning signs, do not automatically trust the alleged expert but rather possibly err on the side of no intervention (depending on your risk aversion); read the medical literature and try to make your own diagnosis following the role model of Richard Feynman; probe by asking questions if you have the skill to test the competence; etc. While the mentioned adaptations are suitable only for some patients and family members (e.g. not everybody has the talent, time and attention to interrogate proposed medical diagnosis and treatment), it shows how the question has its importance/impact quite separate from the question about patient perception.

References

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  1. Why are doctors so arrogant and rude?, quora.com
  2. Why are doctors so arrogant?, quora.com
  3. What Do You Care What Other People Think, books.google.com
  4. Arrogance among physicians by Allan S Berger, 2002
  5. The 'A' Word: Are Doctors Arrogant?, 2014, medscape.com

Further reading

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