Doctors’ clinical inertia as myopia

Abstract

The inadequate physician adherence to current good practice guidelines has been recently described as clinical inertia. The aim of this chapter is to show that clinical inertia shares with patients’ nonadherence to medical prescriptions the appearance of myopia, and may be, at least sometimes, the result of inappropriate use of empathy by the doctor. I propose that clinical inertia occurs when the doctor imagines her patient’s feelings, for instance that she will refuse the treatment, and becomes overly involved in the immediacy of those emotions at the expense of the future. The doctor, in exercising empathy, should not forget that her own preference is different, and that she should propose a treatment which would protect her patient’s future: Not doing it is clinical inertia. Finally, how, in the context of the autonomy principle, someone (a Health Care Provider) can decide what is good (a treatment) for someone else (a patient) without falling into paternalism? Actually this analysis leads to a paradox: not only is the principle of benevolence sometime conflicting with the principle of autonomy, but physician’s benevolence may enter in conflict with the mere respect of the patient; I propose a solution to this paradox relying on the importance of patient education and trust in the patient-physician relationship.