A matter of trust

A doctor and patient
A doctor and patient

What does the Volkswagen diesel emissions travesty of deception have to do with medicine? It was a massive abrogation of trust. And when the news hit that a well-respected Toronto-based academic physician was dishonest in her reporting of important research results that could potentially negatively affect patients – that too was a massive abrogation of trust.

For those of us in the practice of medicine, the vast majority of us have an overriding understanding that our prime concern is the well-being of our patients. That does not mean we are all paragons of virtue, knowledge and blemish-free personalities. Physicians are people who have undertaken the practice of medicine – with its long and illustrious history and legacy. That being said, it is an everyday undertaking and sometimes a monumental challenge to make sure that we fulfil our duties and obligations to our patients and, no less importantly, to ourselves and to our profession.


There is a collective duty to the profession that each physician is expected to fulfil. In almost all jurisdictions, it is overseen in a regulatory fashion by our colleges of physicians and surgeons. We are duty-bound to heed their policies and directives, but the innate commitment that each physician must internalize is what keeps the vast majority of us reputable and caring practitioners.

It is very common these days – maybe it has always been so, but I suspect not – for physicians and the health-care system to be criticized by individual patients and by the media. There is something about medicine that grabs the media – on the one hand, the ever-so-popular TV shows like Grey’s Anatomy or the remote Chicago Hope and on the other, the newspaper stories about one hospital or nursing home or errant physician after another causing an affront to the sensibilities of the public.

When it comes to physicians, I believe the vast majority of us want to do right by our patients. The question for those in leadership positions becomes how to build on the intrinsic desires of physicians to fulfil their natural and professional wishes and inclinations to serve their individual patients and the general public. It is not always easy: sometimes, for example, when political forces and circumstances mount, as periodically happens, physicians generally feel that there is pressure on them that might ultimately compromise not just their personal well-being through funding decisions, but ultimately their ability to serve the needs of their patients.

It is not that physicians do not know the realities of economic constraints – such things are part of all of our lives, whoever we are – it is just that when making medical decisions, it is sometimes hard to factor in relative costs and financial impacts, when at the end of that equation is a patient and sometimes in the world of aging, the family of that patient.


Hope springs eternal. It was a bit refreshing although understandably very political, that during the recent election campaign, the parties vying to replace the Conservatives promoted a substantial agenda for the burgeoning aging population. Even though the health-care portfolios sit within the provinces, maybe, just maybe, this time around and with a new government, there will be a translation from political promises to actual investment through the provincial channels in a way that those physicians and other health-care providers, and the facilities and programs that serve the older population and their supporting families will get the help they need to promote their well-being.

And maybe, within that complex interaction with practising physicians, the ability of each and every one of them will be supported and promoted, in keeping with their long legacy of dedication and most important, trust.