The Platinum Rule asks clinicians to look at their values

(Forgive the stock photo above)

You may be familiar with what’s known in the diabetes and medical community as #languagematters. It began as a global advocacy movement and now has a lot of research and recommendations behind it. As you might imagine, it reminds health professionals that the language they use with people who have diabetes should not be judging and negative but realistic and supportive. That this affects outcomes.

Similarly, this morning I read in the Scientific American, “Beyond the Gold Rule: Clinicians need to understand patients’ values, not apply their own.” That what also makes a difference in how we tend to people is values. Physicians, largely, of course not all, tend to swim in the sea of their values mostly ignorant of their patients’.

As the author, science journalist Claudia Wallis, points out, “We have to acknowledge the ways in which our own personal biases can shape the way we perceive and respond to patients.”

Here’s a brief excerpt from the article:

“In the arena of medicine, the stakes for making or influencing choices for others can be especially high. Such choices impact people’s quality of life and even their chances of survival. As health care becomes less paternalistic and more individualized, the time seems right for a new ethical guideline. Enter the “platinum rule,” proposed by Harvey Max Chochinov, a professor of psychiatry at Canada’s University of Manitoba: do unto others as they would want done unto themselves.

Chochinov, an expert on palliative care, eloquently describes this principle in his essay “Seeing Ellen and the Platinum Rule,” published last year in JAMA Neurology. He begins with a story about a health crisis affecting his late sister Ellen, who was severely disabled by cerebral palsy…”

How refreshing it is to remind all of us that we all see the world according to our unique experiences, conditioning and values. The whole article is worth reading.

5 thoughts on “The Platinum Rule asks clinicians to look at their values

  1. Wow, Riva, thank you! I have struggled in recent years with the behavior, words, and lack of compassion from my healthcare team. From my concierge internist, whose website claims fast response and same or next-day appointments but who doesn’t return emails for many days, takes a 2-week vacation without notice that he will be away, etc.

    Recently, I went back to a GI doc, who, after delivering the diagnosis of gastroparesis, asked why I voiced concern and felt upset. This time, she said she needed to give me tough love when I expressed concerns about my husband’s medical conditions. I was and am still stunned.

    Maybe they are burned out. Maybe they have seen a great reduction in their incomes. Whatever it is, it is NOT patient care.

    • I agree on all fronts. It is not care and I think HCPs have been burnt by the system – endless paperwork, less money, higher patient load…I’m a big fan of internist Danielle Ofri, who works at Bellevue, the countries oldest public health hospital. She’s also an author and has written several books about what she’s learned from her patients. She writes that empathy is trained out of medical students in the third year of their training. Maybe we have to re-train them by saying something when they act so care-lessly. Years ago I fired my endo for not calling me back after I called four times for a test result. When my fourth message was angry, he called me back to say he doesn’t call patients when their test results are fine. Well this had been a retest when the original result was not. That was it, I was done with him.
      Now I love my endo. Fire and hire, maybe we should be the consumers of healthcare they keep telling us we are 😉

      • Riva, I wonder if we could partner with Danielle Ofri to develop a brochure that T1D patients (and others) can hand out to our medical teams?! We could just say that we were working on this project for patient/doctor relationships and compassion … and wanted to share (without chastising them). I would LOVE to help on this!!!

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