I was sat in a weekly FY2 teaching session the other day when the BMA representative who had come to talk to us referenced the latest data showing how doctors were, once again, voted the most trusted profession by the British public. Not for the first time, this piece of information, and the way it was put forward, did not sit right with me. Is this title really justified and is it something we should be shouting about? As scientists we have an obligation to be sceptical when presented with data, especially if we’re going to use it for self-promotion.
According to Ipsos’ 2019 survey, Australia, Belgium, Canada, France, Great Britain, South Africa, Spain and Sweden all put doctors at the top of their respective lists. It seems to have become somewhat of a cliché – with those voting for it susceptible to a heuristic that leads to a self-perpetuating reliability of results, year-on-year from country-to-country. In America, interestingly, the one year in recent memory, according to William Davies’ excellent book ‘Nervous States’, that doctors came in second, was 2001 when they finished behind firefighters. In the light of 9/11, public opinion was at an all-time for firefighters whose bravery had just been broadcast for all to see. But did people really have any new data to evidence the fact that they were ‘trustworthy’?
67% of Britons rated doctors 1 or 2 out of 5 on the scale of trustworthiness – with 1 being the most trustworthy – only 11% did the same for politicians. In truth, it’s a nonsensical metric. It’s an over-simplification of a very broad subject and it does not distinguish between the trustworthiness of the people themselves, the decisions they make in a professional capacity and the profession as a whole. Furthermore, compared to politicians (and advertising executives who propped up the bottom of the table), is it not somewhat simply down to the nature of the work we do? Honesty, confidentiality and impartiality are considered a bare minimum for doctors, compared to those in Westminster who are in the business of opinion, persuasion and ultimately manipulation.
William Davies also talks at length about how the rise of populism has come about in tandem with a mistrust of experts. The opinions of academics are suddenly not warranted in the political sphere and the value of facts seems to have taken a hit. It appears, however, that doctors have thus far remained immune to this swing towards scepticism of the academic elite. People no longer trust ‘facts’ but they still trust us. I wonder if that is at risk, and what our job would look like if we had to make the case to our patients that scientific fact was a valid argument in favour of taking our clinical advice.
A recent spat on Twitter between Professor Sally Davies and Jacob Rees-Mogg MP was triggered by the politician’s ludicrous and crass comparison of Dr David Nicholl and Andrew Wakefield. ‘Doctors are amongst the most trusted people in our country’, the former chief medical officer wrote in defence of her fellow physician, ‘it is worth listening to what they have to say with respect.’ When does the doctor lose that right to have their opinion respected by default and where do qualified doctors that have become MPs themselves rank in terms of trustworthiness? (A subject for a further piece in itself…)
The more doctors foray into politics and wield their power as trusted people, the more they risk being tarnished by the same brush as the countless experts whose claims on the likes of the economic effect of Brexit and the threats of climate change are repeatedly dismissed.
If these polls are to be believed and us doctors are almost universally trusted, what responsibility does it place on us? Should we make our voice heard in political issues that we believe in, as the likes of Dr Nicholl has done regarding the dangers of a No Deal Brexit, given that it is likely our opinion will carry weight? Or rather should we realise our position at the top of the Table of Trustworthiness is precarious, baseless and that one day we could be dismissed as yet another expert sticking their nose in where it is unwanted?