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har·bin·ger | \ˈhär-bən-jər\
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Dramatised presentations of doctors and hospitals in popular culture may be the only ‘insider’ perspective many people receive of the medical profession, beyond their own experience as a patient.
These can perpetuate dangerous stereotypes, for example, depicting surgeons as arrogant, egocentric and hostile, and actually worsen public opinion of real professionals.
Adam Kay, author of the award-winning medical memoir This is Going to Hurt: Secret Diaries of a Junior Doctor (2017), embodies such a portrayal. Kay publicly discussed his deliberate choice as a surgeon to disfigure a woman’s tattoo during a surgical procedure. In the high-profile BBC television version, starring Ben Whishaw, this was displayed as having a vengeful motive.
This story is not an anomaly. Kay’s literary humour while covering heartbreaking stories, in which patients are experiencing the most difficult of times, seems insensitive to many.
Readers and viewers can sympathise with patients in such circumstances, and may even have been in similar situations themselves. When surgeons are presented as antagonist characters, perhaps those who disfigure tattoos or speak rudely to patients, it draws a lasting emotional response.
But to solely blame writers or TV directors for such image problems would be a mistake. I believe that the mass-media presentation of healthcare professionals, especially surgeons, preys upon a predisposed attitude that is shared widely across society.
This attitude could stem from the fact that 83.7% of UK surgeons are male, even though men make up only 36% of those accepted on medicine and dentistry degree courses. Research into the perceived gender stereotypes of surgeons found that men were viewed as more competent than women but lacking warmth.
Women also face many barriers in accessing speciality training, but when they do achieve the right qualifications for the job, they are often dismissed and discriminated against. Many female surgeons, in particular Black women, have reportedbeing mistaken for other members of the healthcare team, or even being asked to remove food trays.
This practice is furthered by the historical under-acknowledgement of female achievements in the surgical field, where male accomplishments have overshadowed these. In the pioneering surgeons listed on Wikipedia, not one of the 24 chosen are female.
Many surgeons can also be seen as hostile due to the way they must distance themselves from their work, which can involve in some opinions seemingly inhumane acts. To do their job properly, they are often less empathetic with patients than perhaps other medics, leading to them being perceived as having an apathetic attitude.
This is reflected in Kay’s use of humour, which comes across as somewhat insensitive at times. In the opening of his book Undoctored (2022), Kay discusses dissection, describing how his fellow medical students joked about the body as a way to hide their nerves. The students were encouraged to ‘pack away their most human feelings’ within one week of medical school.
Surgery is one of the highest-paying medical specialties, both historically and today, and the idea that surgeons are primarily in the profession to make money is common, especially during times of austerity and budget cuts for the NHS.
Rachel Clarke, author of 'Your Life in My Hands: A Junior Doctor’s Story'
This stereotype was particularly perpetuated in the media during the 2016 junior doctor strikes in the UK.
In her book Your Life in My Hands: A Junior Doctor’s Story (2020), doctor Rachel Clarke describes doctors being painted in the media as money-focused, ‘willing to jeopardise patients for the sake of lucrative overtime’.
In fact, the doctors chose to strike due to the advocacy of Conservative Health Secretary Jeremy Hunt for a seven-day NHS at the same time as pledging budget cuts of £22bn, resulting in reduced staffing levels in hospitals and overworked NHS staff.
The most important question to consider is how such stereotypes impact patient care. If a patient mistrusts their doctor, they may omit information, which can potentially compromise their safety – a patient’s history is crucial when deciding a course of treatment.
Stereotyping could also lead to increased anxiety which can increase symptom severity and negatively affect recovery from procedures. Patients who do not trust their surgeons may not follow post-operative care regimes, possibly compromising and inhibiting recovery.
Inaccurate perceptions of the profession may also deter potential future medics from choosing a career in healthcare, which could result in increased difficulties with staffing in the future, worsening the strain on the NHS which is is already suffering shortages.
The NHS is facing a wider image problem, which includes discontented staff, compromised patient safety, and misinformation. Surgeons are just one profession caught in the mix.
Trust is key to the doctor–patient relationship, and therefore key to effective patient care. Stereotypes such as those experienced by surgeons compromise this, and we must take steps to alleviate this.
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