I want to reflect on how personal values and attitudes can impact on professional decision making in the health and allied health fields. This thought has been in my head for some time due to various incidents that I have either witnessed as a practitioner or as a 'patient'/client or have been relayed to me by a friend.
I believe that it is important to be cognisant of our values and attitudes in all aspects of life. It is critical, however, when we are responsible for the welfare of another. In psychological and counselling practice, this is usually emphasised in professional supervision which is strongly encouraged for any practitioner, if not mandatory if you are employed in government or non-government organisation (as opposed to working in your own private practice).
Why does this matter?
Well, the observations I've made or heard told would indicate that self-awareness in the medical professions especially seems to be lacking. Not only are certain attitudes expressed hurtful to the patient at the time, and thus could indeed stop a person from seeking medical attention in the future; but I am also concerned that the decision-making process in deciding treatment could also be adversely affected.
A couple of examples:
Olinda* was told she could probably do with losing weight when she presented at an emergency department after throwing up for several days, and after giving her an anti-nausea drug intravenously and then sent Olinda home. The anti-nausea drug was only effective for a few hours once home. Olinda continued to vomit for another three days.
Frank was asked if he had sex with men, and when he said he didn't then the GP said he didn't see the need to test him for sexually transmitted infections. I believe that the GP knew that Frank's partner had other sexual partners.
I've had a GP speculate that perhaps I was a lesbian, and my partner likes 'that sort of thing', when I wanted to stop the contraceptive pill some years ago. I was too gobsmacked to be able to give an intelligible reply but needless to say that I didn't return to see this doctor again.
I can think of countless others, including ones where I have been either the patient or a support person for the patient but these are a little too distressing to go into.
As a professional, the most common situation where personal attitudes and values raised my concern was when clients with particular presentations and/or diagnoses came into contact with medical or psychiatric triage. I am thinking of, in particular, people who present at a hospital emergency department or call the psychiatric crisis assessment team. Those who have worked within the 'pointy end' of public mental health are probably all too familiar with the types of responses that clients can receive, that can often be experienced as rejection and uncaring. I am not going to pretend that supporting these types of presentations is easy but a whole team approach, along with solid supervision, can help.
Which leads me back to a question: what sort of training and supervision do those in the medical professions receive? Are they encouraged to reflect on their personal values? Is this changing? Are those who have been trained more recently encouraged to consider these kinds of matters when practicing while older professionals were left to just feel their way through?
I wanted to write this without doing any particular research, as I often have ideas but I have found in the past year or so that feeling that I need to undertake research puts a halt to my writing and hence the long time between posts.
I am sure that there are plenty of other examples that people reading this could share, some far worse than those examples above too.
*names and some other details have been changed.
