IT IS a sentiment commonly uttered by teachers in higher education: that we learn as much from our students as they do from us. You might advise any student hearing such pieties to demand a return of the tuition fee; and, at times during Tell Me Where It Hurts (Radio 4, Tuesday of last week), one might have felt the same, as GPs and other medical professionals insisted that the best health care was that which shared the decision-making; in which the doctor is not expected to know best.
It is all about shared understanding, which is why, at Birmingham University, there is even a Professor of the Shared Understanding of Medicine.
The paternalist days, when a GP consultation began with a brusque “Drop yer kecks and say ‘Ah’” are thankfully long past. GPs are now required to wear a reassuring smile and maintain a sense of order. It is a performance; and one that is now increasingly participatory, as GPs attempt to mitigate the “power asymmetry” in the doctor-patient relationship.
There is a very good reason for that power asymmetry: it is founded, on the one hand, on seven years and more of medical training, and, on the other, on ten minutes of internet browsing. Don’t misunderstand me: I would be delighted to have somebody like the presenter Dr Margaret McCartney as my GP; and the prescriptions that she and those she interviewed were recommending for good practice seem eminently sensible — not least, maintaining a relationship with one GP during the course of an illness.
But underlying this entirely worthy documentary lay an anxiety about patients’ expectations, their arguably misguided sense of empowerment, and, more generally still, an apparent nervousness on the part of the experts to assert the status granted them by their expertise. Power asymmetry is not always a bad thing.
One of the dangers here is that the laudable development of “soft skills” in professions such as medicine might be used as an excuse for under-investment in more direct forms of intervention. Thus, it was notable in Mishal Husain’s report from HM Prison Wandsworth on the Today programme (Radio 4, Saturday) on choral-singing workshops in prison, that one inmate had signed up to sing because he was not able to see a mental-health professional.
Nevertheless, M. J. Paranzino’s Liberty Choir is able to facilitate emotional and social engagement in ways that the prison schedule rarely allows. In Late Junction (Radio 3, Wednesday), we heard work from two artists whose collaborations with prisoners have resulted in new music of passion and tenderness.
Space allows only passing mention of Living Memory (Radio 4, weekdays), a delightful series of interviews with UK centenarians. In their accounts of lives long and involved, fate and faith are neatly poised; but there is no escaping a dread not for their futures, but for ours.