Psychological Code of the Medical Profession in Turkey

Factors that make the Medical Profession the most stressful Profession

• Living with death.
• Not being able to strike a balance between career and family life; family conflicts.
• Social, economic and legal sanctions that lessen autonomy.
• Patient’s that associate the doctor with an undesired object.
• Conflicts between colleagues because of the competitive work environment.
• Being overworked.
• Necessity to keep updated on any new information and developments.
• Worrying about the possibility of making mistakes.
• Political, economic and legislative pressure.
• Routine heavy work load.
• Unsuccessful treatment cases.
• A perception of inadequacy due to age.
• Particular problems that female doctors experience.

Types of Stress Factors

• Difficulties arising from the patient-doctor relationship.
• Difficulties arising from the relationship between colleagues.
• Difficulties related to preserving performance level.
• Emotional challenges arising from the profession itself.
• Administrative, social, economic, legislative and political challenges.

Factors that counter-balance the stress factors

• Freedom in decision making, being able to use one’s creative powers, autonomy.
• Strength obtained from sublimation and altruism.
• Satisfaction gained from prestige and economic advantages.

In today’s world the number of stress factors has increased whereas the number of factors that create a counter balance has decreased. For instance, administrative pressure has increased whereas balancing factors like prestige, autonomy and economic advantages have decreased.

A Study carried out at Istanbul University (İÜ) Cerrahpaşa Medical Faculty
56 women, 94 men, a group 150 doctors in total.
Age average 33,87+/-9,32, min 24, max 66

Generally Accepted absolute Success Criteria

• Empathy.
• Definitely do not attempt to find solutions!
• Do not live through the confusion of alternative diagnoses!
• Do not forget the loss and damage that the patient will suffer!
• I take the socio-economic status of the patient into consideration !
• I find out about the socio-demographic characteristics!
• I want to be understood !
• I do not want to be authoritarian!

Number of doctors who comply with the absolute success criteria: 2

Indicators of searching for a solution

Need to ask for psychological advice.
Consultation liaison psychiatry is important!
Number of doctors who are in search of a solution: 139

Reasons why doctors search for psychological solutions for their patients

It has an impact on:
• the patient following recommendations,
• speed of response to treatment,
• the patient’s self-respect.

Characteristics of people who wish to be educated on human psychology

• they believe that a friendly relationship with the patient will not jeopardize their authority.
• They place particular importance on CLP (Consultation-Liaison Psychiatry).
• They tend not to try and find definite solutions.
• They request more frequent psychiatric consultations.
• They keep away from problematic patients.
• They are in greater need of psychological support.
• They have stronger omnipotent tendencies.
• The request for solution searching is less in experienced doctors.

Speculation

Doctors with omnipotent tendencies are unsuccessful in their relationship with patients. This increases their tendencies towards depression. They give up the goal of finding a definite answer. On one hand they are inclined not to provide information to the patient and to keep away from problematic patients, on the other hand they believe that a friendly relationship with the patient does not jeopardize their authority. Therein lies the contradiction. This contradiction is a result of omnipotence. As a precaution against Narcissistic injuries, CLP applications become more frequent. They rationalize by thinking that the problem does not lie with them but with the education system.

Conclusion

Behind the requests for an education in patient-doctor relationship may lie the hope to feed an authoritarian-totalitarian-dogmatic professional approach.

The source of the tendency towards omnipotence

When choosing their profession, they may have been influenced by the popularity of the profession, the economic advantages it will bring, or by others. The tendency of unfulfilled parents to fulfil their desires through their children is a particularly important point. In short, some doctors are forced to be omnipotent due to certain sociological reasons.

In our times, the reflection of the approach of the elitist doctor who looks down on his patients from a lower socio-economic level, establishes itself as the loss of the support of this vast mass of people. It is essential that we as doctors have to enter a process of self-criticism, and become aware that with regards to experience and accumulated knowledge we should only be one step ahead of the masses. Surely the correct approach must be to give up the elitist approach hidden within Narcissism, to provide the quality of service that the public deserves, and not to be estranged to their moral values. As a result the public’s support will be gained against this aimless pressure that governing forces seem to put on doctors, and problems will settle at the level which they should be at.

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