{"id":74715,"date":"2022-08-01T20:27:00","date_gmt":"2022-08-02T00:27:00","guid":{"rendered":"https:\/\/www.shortform.com\/blog\/?p=74715"},"modified":"2022-08-08T12:10:25","modified_gmt":"2022-08-08T16:10:25","slug":"do-doctors-really-care-about-their-patients","status":"publish","type":"post","link":"https:\/\/www.shortform.com\/blog\/do-doctors-really-care-about-their-patients\/","title":{"rendered":"Do Doctors Really Care About Their Patients?"},"content":{"rendered":"\n

Do doctors really care about their patients? How much of health care is about the appearance of care as opposed to substantive help?<\/p>\n\n\n\n

In The Elephant in the Brain: Hidden Motives in Everyday Life<\/em>, Kevin Simler and Robin Hanson say that many of our social systems are driven by ulterior motives. That means that some of our most important institutions\u2014including health care\u2014are built around goals we\u2019re not even aware of.<\/p>\n\n\n\n

Keep reading for the authors’ argument on institutional hidden motives.<\/p>\n\n\n\n\n\n\n\n

Health Care Lets You Look Caring<\/h2>\n\n\n\n

Do doctors really care about their patients? Undoubtedly, medical professionals exhibit genuine concern. However, the authors argue that medicine isn\u2019t just about healing\u2014it\u2019s also about showing conspicuous care<\/strong>. They give the example of a mother kissing her toddler\u2019s scraped knee to \u201cmake it better.\u201d This practice has no physical healing power, but it\u2019s a social ritual that shows the mother cares and lets the child feel cared for. <\/p>\n\n\n\n

Simler and Hanson argue that this ritual extends into our adult lives. For example, they point out that, when someone gets sick or hurt, it\u2019s common for friends, family, and community members to bring that person food. They argue that bringing food signals that you care\u2014as with charity, it advertises your compassion and selflessness. Meanwhile, receiving food broadcasts your popularity and support (conversely, if nobody helps you when you\u2019re in need, that doesn\u2019t speak well to your status in the community). <\/p>\n\n\n\n

Simler and Hanson further argue that our professional health care systems function as a larger-scale conspicuous care ritual that leads to medically inferior decisions<\/strong>. They argue that this is why patients and doctors seem to prefer active interventions over watchful waiting (monitoring a patient\u2019s status but not intervening unless symptoms worsen) or nonmedical preventative strategies like lifestyle changes. They suggest we want our doctors to be \u201cdoing something\u201d so that we know they care about us (and likewise that doctors want to show their caring via active interventions). <\/p>\n\n\n\n

Likewise, they argue that this is why, in end-of-life situations, patients and their families choose aggressive interventions (which come with great cost and limited efficacy) over palliative care. Palliative care focuses on managing a patient\u2019s symptoms and maintaining or improving quality of life; it can be used in conjunction with curative treatments or, in the case of terminal disease, it can include measures like hospice care. By contrast, aggressive treatment means, for example, continuing chemotherapy and drug treatments (which typically have strong side effects) and performing surgery even when there\u2019s no hope of curing a disease.<\/p>\n\n\n\n

Simler and Hanson argue that patients (or their family members) often opt for the aggressive option because it sends the message that you care about your life (or your loved one\u2019s life). They say that choosing palliative care\u2014even when it\u2019s objectively the better option\u2014seems to <\/em>send the message that you\u2019re okay letting yourself or a loved one die.<\/p>\n\n\n\n

An Alternative Explanation of Unnecessary Health Care <\/strong>

Simler and Hanson\u2019s account doesn\u2019t include a number of psychological and practical explanations for some of the phenomena they discuss, none of which have anything to do with signaling. For example:

Patients\u2019 decisions about their own health care could be influenced by factors as subtle as the order in which they receive information<\/a>. For example, you\u2019ll probably be less inclined to get a procedure if you hear about its risks before hearing about its benefits. Similarly, if a doctor presents options for active intervention before presenting an option like watchful waiting, that might bias you toward the active option.

End-of-life patients might opt for treatment rather than palliative care because they\u2019re afraid of death\u2014or don\u2019t want to admit that they\u2019re dying. Similarly, they might opt for treatment because their doctor is uncomfortable discussing end-of-life options<\/a>, resulting in patients having unclear understandings of their situations.

Doctors might pursue treatments based on incorrect assumptions about their patients\u2019 preferences<\/a>. For instance, when treating breast cancer, a doctor might choose treatments designed to preserve the breast even though that might not be a priority for the patient.

Doctors sometimes override patients\u2019 advance directives<\/a> (written instructions about when and how a doctor should try to save a patient\u2019s life) to provide life-saving care the patient didn\u2019t want. The reasons for this aren\u2019t clear, but experts suspect it\u2019s in part because doctors are trained to take action, not to sit by.

Doctors often order unnecessary tests to cover their bases and manage risks.<\/a> Doctors and patients alike are uncomfortable with uncertainty, and testing gives the (often false) impression of knowledge. Plus, doctors fear being sued for malpractice if a patient gets sick or dies from something that could have been caught by a test.

Overall, it seems there is indeed an elephant when it comes to health care\u2014but rather than being about hidden motives, this elephant has to do with patient-doctor communications (and fear of lawsuits). 

Taming the elephant: <\/strong>To minimize the chances of unnecessary tests or procedures, have open and honest conversations<\/a> with your doctor\u2014and be aware of how the illusion of control might bias you in favor of testing and active interventions.<\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"

Do doctors really care about their patients? How much of health care is about the appearance of care as opposed to substantive help? In The Elephant in the Brain: Hidden Motives in Everyday Life, Kevin Simler and Robin Hanson say that many of our social systems are driven by ulterior motives. That means that some of our most important institutions\u2014including health care\u2014are built around goals we\u2019re not even aware of. Keep reading for the authors’ argument on institutional hidden motives.<\/p>\n","protected":false},"author":9,"featured_media":74717,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[20,16,24],"tags":[708],"class_list":["post-74715","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ethics","category-health","category-society","tag-the-elephant-in-the-brain","","tg-column-two"],"yoast_head":"\nDo Doctors Really Care About Their Patients? - Shortform Books<\/title>\n<meta name=\"description\" content=\"Do doctors really care about their patients? The Elephant in the Brain argues that health care is driven by selfish motives. 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