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Goldman tells profession to “aim high”

When it comes to the unique value that physicians bring to society, Dr. Brian Goldman urged CMA delegates to “aim high” and expand the scope of care that physicians provide to patients and society.

Goldman, an emergency physician and host of the popular CBC radio show White Coat Black Art, gave the keynote speech at a strategic session on professionalism during the CMA’s General Council meeting, in which he focused on his new book – The Secret Language of Doctors – about the use of slang in medicine.

“Slang symbolizes current beliefs and attitudes and I think we should pay attention to them,” said Goldman, in discussing many of the slang terms used by physicians and other health care professionals when dealing with patients and each other.

Much of the slang used in medicine describes issues involving medical futility and the challenges of dealing with patients at the end of life. Such situations often reflect the deep moral distress physicians face when dealing with cases where patients are dying but the care expectations held by the patients and their families are different.

Goldman also touched on slang used by physicians to describe other physicians: he described this as a “lack of empathy” between doctors.

Overall, Goldman said he “skates down the middle” on whether the use of slang is productive, but he affirmed derogatory slang terms referring to patients should be eliminated. “I believe there will always be a place for slang,” he noted.

He said use of slang, or argot, in the medical work environment reflects symbolic or medical cultural issues and could reflect frustrations that need attention.

Speaking about the unique value proposition document prepared for the CMA and discussed over the last two days, Goldman said it reflected goals that are lofty “but not lofty enough.”

He argued the document understates the fundamental role physicians play in diagnosis, and also the fact that physicians have an unprecedented opportunity to define their own practice.

Goldman’s presentation was made available through a live webcast, with online comments on the address posted for delegates in the meeting room to see. Underscoring the reach of social media, the hashtag used for the meeting (#cmagc) was the fifth most popular hashtag used in Canada during the time period when Goldman was speaking.

Much of the discussion in an education session on Sunday, and following Goldman’s presentation, focused on three key areas the CMA has identified as defining the unique value of physicians: the knowledge physicians hold, the application of that knowledge and accountability.

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