“I don’t know” 

These three words are arguably the most difficult words for any practitioner to utter. There are moments during any consultation where a practitioner in charge of a client’s/patient’s care needs to make a call, and this call tends to come in two forms; forming a response to a client’s question or making sound judgments and decisions about how to treat/manage the client’s presenting case. In either of these scenarios, the practitioner can commit fault in several ways, including making an incorrect response to the question or an incorrect judgment call about the client’s treatment.

So where exactly does the inclination to commit these clinical errors come from? There are several places where this can stem from, such as having a lack of technical knowledge/experience to know the correct course of action or operating out of outdated models of practice or school of thought, a topic that I elaborated upon on the post titled “faulty diagnostics and misappropriated treatments”. But the reason that leaves me with the sourest taste and a generalized disappointment in practitioners comes from when they operate from a place of arrogance, or, in better words, from having too much pride in oneself.

 Integrity 

“adherence to moral and ethical principles; soundness of moral character; honesty”

Morals

 “of, relating to, or concerned with the principles or rules of right conduct or the distinction between right and wrong; ethics” 

Here, we realize that clinical errors don’t always stem from a lack of training or experience, but from errors in human conduct, or a lack of integrity. Committing errors from a place of lacking integrity is leagues worse than committing them a place of misunderstanding, as the former represents a violation of professional ethics, and the latter represents common human errors that every single practitioner makes throughout their career. Expanding on violating professional ethics, practising from a position of pride leads one to make unethical mistakes because a sense of superiority and arrogance, act as cloaks that render the practitioner blind to their own ignorance. All humans carry a sense of pride to varying degrees, which can help one succeed and navigate the world but if they are used in the wrong setting, it could inflict unnecessary malice or neglect towards another person.

If a practitioner plays a greedy card by misleading a client so they can retain the client’s commitment for monetary gain, or to fulfil their financial objectives, this is certainly unethical, if not bordering on malpractice. Additionally, if a client realizes that a practitioner was incorrect about their opinions or treatments, now the client loses trust in their healthcare provider and it is the responsibility of practitioners to think before they speak and notice when they are speaking from a place of opinion, rather than conviction. 

The interesting phenomenon I notice in healthcare is that no matter what ails a person, any practitioner, regardless of the modality they practice, seems to believe they have the answer, or at least, an opinion. If someone is experiencing depression, they could see a naturopath and be advised to meditate and take an omega-3 supplement with vitamin B12, or a chiropractor might say something amongst the lines of needing regular appointments to “align” their vertebrae so their nervous system functions more “efficiently”, or a psychologist might recommend journaling and delve down the rabbit hole of talk therapy in an attempt to uncover unresolved childhood trauma, or a practitioner working in esoteric forms of physiotherapy, such as osteopathy or craniosacral therapy, might mention the idea of the client’s “soul being on a journey” and that with continuous sessions over the long-term, the client will tap into their innate intuition and will realize on their own, why they are experiencing depression and how to resolve it.

The problem that’s revealed here is that given how practitioners can only reflect their training in the clinical setting, their capacity to facilitate healing will be directly correlated with the amount and breadth of training that they have undertaken. This implies that the more limited or narrow the scope of practice plus less training/experience, the lower chances of the treatment being effective and higher are the chances that the client will not achieve a desired outcome. 

“I wonder how much harder practitioners would work to excel at their professions if their pay was contingent on the effectiveness of their treatment, reflecting how traditional Chinese medicine practitioners were paid back in the day, or physicians in ancient Greece being paid using the “fee-for-cure” model?” 

 If a practitioner works solely from the doctrine of the school of thought (which might be narrow in scope of training) they were trained in without applying the proper detective work, this would be akin to shooting darts whilst being blindfolded, or building a house by laying out ceiling before pouring the concrete base and the framing. This is the trap I referred to above and to prevent faulty diagnostics and misappropriated treatments requires the relentless pursuit of continuous training and education, a noble ambition that every single practitioner should be mandated to pursue. Furthermore, I question whether “continuing professional education” is a reliable method of ensuring that practitioners keep up to date with current research and treatments because there are no rigid measures set in place to ensure that practitioners do not use outdated information. Healthcare is not static and the moment a professional in the field says that they don’t have anything new to learn is the moment they have retired from their profession. 

Practitioners should not underestimate the privilege that they have, to bestow healthcare to others or the gravity of the responsibility they have, to deliver the best service possible, whilst having the goal of resolving the complaints or maladies that their clients have sought their care and professional opinion for. Additionally, the weight of the faith, hope, trust, effort, and money that a client pays, should never be taken for granted and that by treating them incorrectly or unethically, they are robbed of these precious resources and are left with a brewing resentment and scepticism towards healthcare. In an industry where the actions of one professional can affect the reputation of their field as a whole, it pays in spades to be mindful of every action you perform in the clinical setting and it will only inspire trust from others if you are willing to have a vulnerable, human moment and admit that are not sure of what path to take or that you don’t know the correct response to a client’s inquiry or that the best course of action is to refer them to another practitioner who may have a better understanding. 

“I’m not sure about that, but I will look into it and get back to you”