CBC’s “Dr C” and the problem of doctor-centred care

A CBC-hosted blog has been following the story of “Dr C.” CBC describes him as “a St. John’s physician training in internal medicine. He’s also a writer, and he’s documenting his life since being diagnosed with cancer.” His blog posts show up on the CBC Health twitter account periodically, and they pass through my newsreader on a fairly regular basis.

For the last few months, I felt uncomfortable every time I saw one of his blog posts go by, and I couldn’t put my finger on why that might be. I think today I can finally articulate my misgivings.

A doctor’s privilege

I feel like the underlying assumption for CBC’s intense coverage, and the voice that “Dr C” has in expressing his experience with cancer is that when it’s a doctor who is diagnosed with cancer, he will have some interesting insights on the matter. In fact that’s the whole premiss of the “Dr C” blog. This makes me uncomfortable because in the modern medical system, a doctor’s voice is always the most important.

Fortunately, this is less the case than it used to be, to be sure. It used to be that nurses were trained to stand up out of respect when a doctor entered a hospital room, for example. But even today in 2014, the opinion of a doctor is, on the last analysis, the only one that really matters in the healthcare system, and in a lot of ways, that shouldn’t be the case.

What is patient-centred care?

Before a conspiracy theorist mistakes what I’m writing about, I want to clarify that I’m not saying that an untrained quack should be given the same voice as a medical doctor on issues like vaccine safety, or the efficacy of “alternative” medical therapies. I’m not advocating for that at all. I’m fully on the side of medical science, and I have rather mainstream views on that matter, even though I work in the Medical Ethics Unit. (It turns out that the real evils of drug development and medical practice are rather mundane things, mostly done under the light of peer-reviewed scrutiny. Go figure.)

What I’m talking about is patient-centred healthcare, a concept that most medical professionals agree on, or at least pay lip-service to. It is a somewhat nebulous umbrella concept, and it is aspirational in nature—a healthcare worker can always try to be more patient-centred.

The idea itself is not controversial. Every healthcare worker would likely say that she wants to be patient-centred, and this includes things like catering her care toward the patient’s own idiosyncratic values, taking into account the patient’s strengths, and seeing the patient’s family as the unit of care, rather than maintaining the fiction that it is possible to treat a disease process in an individual without regard for the rest of the patient’s life.

So what’s the problem with Dr C’s blog?

I have nothing against “Dr C” from the CBC. I think it’s terrible that he (or anyone) has cancer, and I wish him the best in his treatment and recovery. I’m even glad that his blog has given him a place to work through his thoughts. I hope that he’s a more sympathetic physician as a result, and that his insights have helped other people to deal with their own cancer diagnoses.

That said, I feel like the way in which a doctor’s opinions are privileged in any discussion on healthcare is very troubling, and I can’t shake the feeling that this blog pushes it even one step further. It’s as if they’re saying that privileging a doctor’s voice when he’s the one treating the cancer isn’t enough. We also have to get a doctor to tell us what it’s like to be a patient as well, because then it will be something worth listening to.

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The Grey Literature

This is the personal blog of Benjamin Gregory Carlisle PhD. Queer; Academic; Queer academic. "I'm the research fairy, here to make your academic problems disappear!"

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