“Doctors are held to a higher standard”
There have been countless times when I’ve heard that statement. It’s some undocumented mantra applied to everything we do. We are expected to be the epitome of health – diabetes, cancer and obesity free. Additionally, we are scrutinized for how professionally we dressed, whether we drank alcohol or smoked (or got a bit high). Our competence was based on who we dated/married, how many children or piercings we had, who our friends were, whether we partied, even our choice of religion and sexual preference.
The lines between personal and professional lives and decision-making have been blurred. They have crept into another arena – doctors’ freedom of speech.
I Had a Dilemma
I was excited to write about the importance of us doctors taking a real vacation (will insert link here). However, this past weekend I had a dilemma. There were circulating articles and general commentary among colleagues and it got me thinking… Do doctors have freedom of speech?
There were times I chose my words carefully because I didn’t want to offend a colleague or my profession. I typically didn’t engage in public conversations about politics and other hot-button topics because I didn’t want my patients, colleagues or the public to feel that my opinions affected how I practiced. After all, perception is everything.
I limited my response to a really good medical-related joke because a layperson would find it insensitive. Some things I’ll never find funny, but my humour is dark, so I’ve chuckled at some jokes. Just admitting that is fine as a human, but as a doctor? Oh the horror!!!
A patient doesn’t want to think that their physician will potentially find them entertaining, but we’re people too.
Thus, our perspectives are not limited to our careers as doctors, but involve the world we live in and life in general.
So, we should be free to express ourselves, right?
The Myth and Our Truth
I decided that doctors’ freedom of speech was a topic too pressing not to address. The myth is that we as doctors can say whatever we want. Our truth, however, is that our expressions come back to bite us – HARD. Dr. Cathleen London shared her story of how she had to remove multiple social media profiles. Some readers did not agree with her post on a medical topic. They reportedly relentlessly cyber-bullied and threatened her because of it. Worse, she did not have sufficient support from her medical fraternity.
Dr. Daniel Sokol, with regular reference to Sir William Osler and his concept of impeturbability, emphasized the importance of caution with the use of social media. He theorized that its use by physicians undermined our profession and patients’ perceptions of us. This in turn, produced patients who were less confident in our capabilities and more likely to sue.
On the flip side, there are some notable physicians who have made or enhanced their careers through social media.
But does our online presence help or hurt us?
“Snitches Get Stitches”
This phrase (pun fully intended) is quite applicable when it comes to doctors’ freedom of speech. We have resorted to guarded side chats, private social media groups – and worse – internalizing our frustrations. We fear reprisals from colleagues and superiors, lawsuits or negative reviews from patients, and even loss of our livelihood due to being blacklisted.
Someone recently shared a very sad news article on a social media platform. In the exposĂ©, “junior” (non-attending/consultant) physicians lamented about alarming infrastructural, resource (human and equipment), and supervisory deficiencies in a Jamaican hospital. The details painted a grim picture of a health system which was failing its staff and patients. Everyone deemed responsible should be scrambling to address the issues. Instead, they are likely investigating the identities of the “snitches” with the intent of covertly decimating their careers.
The Sacrifice
Freedom of speech can cost us the career we worked so hard for.
No one can dispute this. Our sacrifice to establish ourselves would come to naught. When we speak out, the punishment is severe.
So, do we sacrifice our right to speak instead? It’s a tough question which can only be answered by the individual.
In the meantime, we hide behind our thin veils of anonymity. We post “tame” photos. We don’t friend/follow/comment on certain people, complain about our work publicly, or start an online feuds. Many doctors will not express our opinions about politics, abortions, race relations, or our burnout.
We transition from people to machines, unfeeling AIs who just happen to have flesh, blood and a soul. Because we are not people; our career is all that we are, right?
Take a moment to reflect on whether or not your life feels limited because you feel silenced. Freedom of speech is not only a right, but a gift, albeit one with consequences.
Find your balance and choose your own path. Get a life, not an existence.
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