Authority in health care
I enjoyed reading your well written post @steelweaver ! I have a rich medical history and although I had a brief run in with acupuncture, I never really went for it. I’d still like try it out when the opportunity presents itself.
It’s an interesting remark on the authority of health practitioners @steelweaver and @Noemi . I think the reliance on guidance by an expert is in large part the result of the patients not being as familiar with acupuncture as the expert. Yet patients are there for a reason: at some level, they believe in the positive potential of the treatment. This common belief of both parties is the base for authority and lends you, or the practitioner, as an expert the authority to give direction. Authority governs the interaction and when nobody (or nothing) assumes it, confusion arises. To be clear: authority is different from power.
I can complement this with my personal experience in the standard healthcare system in Belgium. For a little over 5 years I had a series of serious physical afflictions, which didn’t ever seem to heal or resolve themselves and only got worse over the years. At the start I always left the clinic with a smile, which always disappeared in days, weeks or months as the situation deteriorated again. I experienced first hand that I was just a number, and that treating symptoms is faster and easier. Good thing for pharma companies, because endlessly treating symptoms sells more drugs. Finding the real cause takes longer, is harder and is more expensive, at least in the short term.
I got pretty skeptical about the system by going from doctor to doctor and spending more time in physiotherapy than with my friends or family. Gradually I lost belief in the system. It was after I ultimately found the cause and cure (very simple ones at that) that whatever remained of my belief vanished. With that gone, there was no more common belief between me and the doctor, so the authority vanished. My language can’t hide it: I found the solution, not a doctor or a system. For this specific illness, I will not lend authority very easily anymore either. I’m lucky, as I have a general idea of healthcare through my studies and know my body well by now, but this is clearly problematic for the general population when you hear similar stories with unhappy endings.
Also interesting that (at least for me) a big part of the authority of the health practitioner is due to belief in the system, rather than a belief in the knowledge of the doctor (which I never really doubted). I think that might be a western thing, linked to what surfaced in the discussions with @alkasem23 about differences in care with Syria: in the west we put our trust in and rely on systems rather than other people. In some other cultures, people probably put their belief mainly in a person, the doctor.
Easier interactions through the internet, powerful search engines, a lot of people sharing experience and stories online, easy access to second opinions (in my country anyway)… Though they don’t always provide correct information, these factors also lead people to challenge the authority in terms of knowledge of the practitioner in the classical doctor’s office. I think both this challenging of knowledge and the failure of the system will inevitably lead to some fundamental changes in healthcare.
Importantly, authority cannot simply disappear, the common belief has to shift to something else. Most stories of experimentation with new methods in the stories here on Edgeryders share some sort of community aspect. This illustrates a shift to lending authority to a collective rather than a system or a person. The collective can consist of patients, doctors or other caregivers and is likely a mixture ideally. In Syria the collective is mainly the family, according to Alkasem.
Looking through this lens of authority is interesting and can be applied to many aspects of our daily lives. The matter is fresh in my head from a Dutch book I just finished reading, which I hope gets translated to English. If anyone is interested: the book builds on work by Hannah Arendt that you can certainly find 