“Room of Suspicion” – Discussion and Article

Published Date: 02-04-2022 – 11.06

Chronicle: Robert BormanDoctorate in general medicine. And a specialist doctor in ALIS South

«In the trust room The doctor thrives. In the anxious room the doctors are burning »now deceased Social Medicine and Professor Per Vogelli wrote in a column in the Journal of the Norwegian Medical Association in 2001, under the title “trust”

Fugelli began the article with the words: “Trust is the ‘material of God’ that unites the patient and the physician.” He further wrote that “Personal trust arises between people who have names, feelings and faces. Personal trust must be gained actively. Social trust is trust in institutions such as Parliament, the police and health services. Social trust develops between people and faceless and emotionless abstract ideas.”.

“Reforming public sector confidence” The current government described it as one of the government’s most important projects. employment government websites Can we read: “An important goal of the work will be to find solutions that provide more space and time to the front lines in both the state and municipality, so that they can better serve the residents.”

room for distinction. The ‘Blue Recipe Affair’ has done just that Comprehensive play area She now testifies that social trust in the authorities is weak: the “chamber of trust” has been replaced by the “chamber of distrust”.

The European Parliament voted unanimously in 2019 to amend the law that opened it Penalties in the form of personal fines For doctors up to 200,000 crowns. This happened under another government, and it is a mistake to blame all of the current government. But the parties that make up the current government shared the same unanimous decision in 2019.

special commitment. When the current government describes itself as “trust reform” as an important taboo issue, it creates a special commitment to “cleanup”. Another party spokesperson said VG: “When we get bogged down in a decision that has undesirable consequences, all we lack is that we have not taken responsibility for cleaning up.”

Experienced medical association Extensive support from patient organizations, who expressed serious concern that doctors could be fined if they wrote a blue prescription on the wrong basis. Anxiety was equally related to patients being harmed. Without patients’ trust, a GP chart is just an empty shell.

as a revival. Reading Per Fugelli’s article from 2001 with the glasses of 2022 is almost a revival at a time when the Norwegian general medicine narrative is marked by dystopia and social distrust. Institutional mistrust of the authorities towards doctors – the ‘blue prescription case’ – and GPs’ mistrust that the authorities have enough will to rescue the GP scheme, as a ‘room of trust’ is created every day by what Foggili called ‘custodians of trust’.

“We have been weak to the strong disciplines of politicians, bureaucrats, the market, science and corrupt consumers – at the expense of independence and trust in public practice. The past 20 or 30 years have been a sad and long decline »Fugelli wrote in 2001.

I don’t even dare to think what he meant by the development in the past five years.

components in learning? I want to be part of the fight to maintain this ‘chamber of trust’, because I see how the chamber of anxiety grows in the daily work of many young colleagues, and how fear of fines or complaints comes to govern clinical practice. When I’m teaching/supervising and emphasizing what is meant by the medical art of general medicine, with an emphasis on the “chamber of confidence”, I sometimes feel like I’m describing more of a phrase than a “divine substance”.

The meaning of ‘room of confidence’, intended by the art of medicine, is not entirely self-evident to a medical student or to a new physician. However, this can be so learned that it can be used as an element in further learning, when the development of experience and competence means that the clinician largely recognizes the ‘confidence room’ as the foundation of the art of medicine.

Fugeli also wrote: “Trust develops in long-term relationships. The GP scheme is an investment in trust ».

There are many indications that politicians today have forgotten this, and to a large extent they see the GP chart as a tool that can be used for many purposes regardless of how this affects the doctor-patient relationship, and the status of the GP’s work.

We must dry. How do we achieve such mutual understanding and social trust? Through dialogue and questions, but then we must also dare to ask difficult and perhaps “painful” questions, such as:

• What long-term plan do politicians and health authorities have for a GP plan?
• Why is politicians’ unwillingness to take concrete measures to save the GP scheme seen as mistrust in the work that doctors do in doctors’ offices every day?

Chinese artist and dissident Ai Weiwei recently spoke magazine: “It can be uncomfortable for people [at jeg stiller spørsmål], and “I don’t necessarily need answers. But if I do not ask, I will be part of the answers of others.”.

Hope too? Going forward, I intend to ask more questions, in meetings with colleagues, the Norwegian Directorate of Health and the Ministry of Health and Welfare Services, thus opening up for more reflection, dialogue and mutual understanding. I’m not an opponent, but I’m mainly concerned that the “chamber of confidence” will shrink, and that the “anxiety room” will feed. And I don’t accept that we become totally ‘part of others’ answers’.

at Last answer of the Norwegian Medical AssociationMr. Engfield, who was involved in finding an interim solution to the aforementioned blue prescription case, says Health and Welfare Services Minister Engfield Kjerkul (Labour): “For me, it is important to emphasize that strengthening the GP scheme is one of the main priorities of the government. We will build trust, and not create more difficult working conditions for GPs in Norway. This is why it is important for us to have a good dialogue about the objections raised by the association. Norwegian Medical.

Maybe there is hope anyway?

Additional information: The author of the article does not mention any conflict of interest, but confirms that the opinions expressed in the article belong to him, and are not an expression of the views of the employer.

Dagens Medisin, from Kronikk and discussion section of the 02 . edition