The media and medicine

On the radio this morning there was a story about the falling number of obstetricians and gynaecologists in this country. There were several factors recognised as potential causes of this shortage, and perhaps predictably increasing litigation rates was one of them. I was talking to a midwife colleague at lunchtime, and she was bemoaning the everincreasing caesarean section rate. In my surgery, I regularly have consultations with people who have read something or other in the press about a new treatment for this or that disease, or more usually creating anxiety about treatment that already exists. If I wasn't bald already, I would be tearing my hair out.

I have the perception that 50 years ago if a member of the public went in to see a new doctor, and was asked just before they went in how much they are expecting to trust that doctor on a scale of -10 to 10, an average answer would be about three to five. I have the feeling now when someone new comes to see me that the same would give an answer is about minus three. Why is this?

Perhaps the world is less trusting place. Perhaps the very fact that doctors are able to achieve more, means that people expect more. Despite that rising expectation, medicine is still a limited science and can't provide everything people want. I don't know. What I do know is that people I see are still looking for certainty. They just don't think they can find it from their doctor any more. So they look anywhere.

At the same time, the media, which I admit in this country is generally trustworthy, is filling them up with poorly researched medical stories, whose main aim seems to be to feed this mistrust and anxiety. A vicious circle develops, where people seek vindication of their anxiety by turning to the very media which has caused it in the first place. I believe we are now in a situation where people trust the media more than they trust their doctor. When they read something in the press, this is believed. If the doctor disagrees with it, it is the doctor who has to make the case.

I am more than happy to do this, but it takes time. At the moment I see people at 10 minute intervals. The government in the press seem to think that it should be possible for me to have a full discussion about choice of hospital, review every disease patient has, as well as deal with the presenting problem in that 10 minutes. Of course it takes longer than that. But if I try lengthen the appointments, there becomes fewer of them. When there are fewer of them, the people who have read that I should be available to see them within 48 hours turn to their newspaper editors with grateful thanks for pointing out the failures of the system with sickening accuracy. Those readers, when presented with the next ballot paper, firmly believe that they're not getting value for money for their taxes so vote for lower taxes next time. Funnily enough, this doesn't make the problem much better.

So what is the answer? I think the media need to renegotiate with themselves their role in society. I respect the media. I realise that they do a job which is vital in a democracy. It is right that the establishment is tested. It is right that non-specialists get the opportunity to question specialists. Journalists, with their questioning minds, play an important role in the pointing out of failure and weakness. But it seems they have not realised that they are taking the role of the establishment they are questioning. They are becoming the institution which is automatically trusted. They should learn from a member of the profession which has recently lost that privilege, that it should never be taken for granted, and certainly never abused.