Does kindness matter when it comes to the medical profession? Let’s explore kindness in medicine and its importance in the pantheon of ideal professional attributes.
The UK’s General Medical Council (GMC) recently updated its guidance document, Good Medical Practice. This is the council’s ethical guide which now mentions kindness as an ideal component of patient care. “Treating patients with kindness, compassion and respect can profoundly shape their experience of care,” the GMC says. It tells doctors to listen to patients and work in partnership with them. And kindness is also specified when interacting with fellow health professionals: “You must treat colleagues with kindness, courtesy and respect.”
So far, so reasonable you may think.
But it has irritated Dr Margaret McCartney, British Medical Journal columnist and Glasgow GP. Kindness is a word that has become weaponised, she writes.
Noting how difficult day-to-day clinical practice has become, she says, “it’s much easier to be kind when you are not pressed for time, when your computer is not slow and doesn’t need restarting twice a day, or when you are not having to tell people that the waiting list for surgery is a year long.
“But essentially: the job of a doctor is not necessarily to be kind, liked, popular, or nice. It is, sometimes, to disagree, to challenge, to object, and, at times, to refuse. All of these things may be correct clinically, morally, and ethically, but risk [causing] complaint.”
I don’t share her views on doctor kindness.
For all the democratisation of the doctor-patient relationship in the last 25 years or so, the person who has taken on the role of patient is probably anxious, feels somewhat personally exposed and is worried about the future. So for the doctor to be kind enough to try to put their patient at ease, especially in the first few minutes of a consultation, is actually a professional skill.
In my opinion, kindness makes it more likely a doctor will act in the best interest of the patient. Dr McCartney says she used to share this view: “‘Be kind’ was a suitable recommendation for professional practice,” she says. But she has changed her mind: “I think it is dangerous, and will end up being used as a threat against doctors doing necessary things that may appear to be, or are, harsh.”
I think it is possible to disagree with a difficult request made by a patient, and to be honest and transparent about treatment options and outcomes while being kind to them. In the words of one respondent to Dr McCartney’s column, “I may want a competent doctor more than a kind doctor, but I really want a competent and kind doctor.”
However, any discussion on professional kindness must take account of the very challenging environment in which health professionals currently practise. A health service that is undermanned, dysfunctional and lacking the resources needed for quality care is a difficult one for doctors to work in.
A survey carried out by the Medical Protection Society (MPS), published last week, shows that a third of the 900 Irish doctors surveyed say not being able to do the right thing for patients, or “moral injury”, is affecting their current mental health. Others point to the impact of exhaustion on patient safety (43 per cent) and their inability to take breaks to eat and drink (36 per cent).
Commenting on the findings, Dr Rachel Birch, medicolegal consultant at MPS, said: “Clearly many healthcare professionals in Ireland are becoming increasingly exhausted and disillusioned due to the variety of challenges and pressures they face daily.”
Do these circumstances justify unkind practice by doctors?
I don’t believe they do. Because, in the words of Maya Angelou, American poet and activist: “At the end of the day, people won’t remember what you said or did, they will remember how you made them feel.”