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How Did Doctors Become Serfs?
WASHINGTON — There is no better key to a culture than language. The lilting poetry of everything uttered in Ireland, for instance, shows a depth of spirit that punishing hardship never could obliterate. The directness of New Yorkers places a high premium on honesty, and the indirectness of the French on privacy. The elaborate courtesy of the American South indicates a sense of form and consideration that sometimes overrides the true intention underneath. Also, it’s possible to make extravagant offers in the South, because people can be counted on not to accept. They, too, are governed by what Thomas Mann called “the discipline and energy of good manners.”
But something disturbing is happening in the way Americans talk about each other. They seem determined to drain the language of its essential juices and to rob people of importance. The most egregious example is in the field of medicine. How did doctors come to be called “health-care providers”? It’s a shocking and insulting dismissal of years of training and reservoirs of authority that patients need to confer upon their physicians. It all grew out of the managed-care movement and a deliberate effort to undermine doctors in order to pay them less and impose upon them more. Patients were denied the dignity of the medical practice they had known, and doctors were hounded into other lines of work because that’s what their profession, once respected, had become — a line of work.
The same thing is happening now to writers. When Time-Warner merged with AOL, suddenly the scribes became not authors, journalists or playwrights, but “content providers.”
Universities have become so obsessed with paying their bills and pleasing their benefactors that many of them now refer to their students as “customers.”
The oddest of all is the designation of prostitutes as “sex workers.” This vocabulary flows from the wish of feminists to treat all women with courtesy and to point out that many sell their bodies out of sheer desperation to support children and keep themselves alive. It’s a worthy sentiment, but should language really try to change the degradation of such circumstances? What is happening in all these cases (except, of course, the last) is an ascendancy of corporate/entrepreneurial culture that is rendering everything else secondary and subject to revision. Especially under attack are the professions. Lawyers are among the few to be spared, but they may well be next. Too many are surrendering too quickly, not understanding that their expertise, their creativity, their insight, clear and undiluted, are critical to the success of the whole — business included.
By Jack Anderson and Douglas Cohn with correspondent-at-large Lee Cullum
Dr Butler,
Although I’m unsure why you posted this comment and article on this particular post, I agree with you on some level. In residency, I remember many doctors would introduce themselves to families by their first name, “Hi, I’m Ted, and I’ll be the doctor taking care of you.” And I always used my title, “Dr Swanson.” The reason: there was a great pediatrician at CHOP who taught me as a medical student that families didn’t come to the hosp to see “Wendy,” they came to the hospital or clinic to find a doctor, with years of rigorous training, to help them care for, protect, and cure their child.
I dress up for work. I use the title I earned when seeing patients. And yes, like you, I find it funny when a family will say, “Thanks, Wendy,” at the end of a visit.
But I know I’m not always in good company in this belief. And although I like titles– because I think they help us understand our roles and relationships in the clinic, exam room, etc, I also believe parents and patients have an enormous capacity to help in their own care. The e-patient movement is compelling because of the ways we now learn about illness (experience, internet, etc) But that doesn’t mean we have to disrespect the training and education that doctors have completed. We can have mutual respect.