What Makes a Good Doctor?

A friend has been affectionately haranguing me for ages to write something about the qualities that make a good physician. Her experience with doctors has, shall we say, not been optimal, and what I have taken for granted over my years as indisputable and foundational aspects of patient care seems like a surprise to her.

That being said, I will approach this question from a related but slightly different angle, and I hope you will see why by the end of this excursion. Because I was recently embroiled in a court case, I thought, as I sat and observed the proceedings, about lawyers. I was, in fact, pleased with the approach of my legal representatives, and in the matter that was being investigated the evidence was quite clear.

I’ve had something to do with lawyers over the years. Several were patients, several were hired as advisors and legal representatives for a psychiatric practice group I headed, several consulted me for advice regarding specific cases, and I often presented at family court here in New Zealand in matters pertaining to compulsory treatment. In the States I once sat in on a deposition with lawyers in a nationally prominent suit, an experience which educated me in the art of cross-examination.

Who were the good lawyers with whom I associated, and what made them good? Some colleagues appear to believe that lawyers need to adhere to their specific views, or have particular leanings consonant with their own, especially in the covid pressure cooker and its aftermath. I tend to disagree with them. I’d want a lawyer who, whatever his or her beliefs, knew the law inside out and advocated for me in the strongest and clearest manner, regardless of what he believed. There’s an old adage about a lawyer’s nightmare being an innocent client — which serves, in a humorous way merely to call attention to the strict principles by which a competent advocate should be guided.

I discovered a compelling description of the lawyer’s role by chance, which I will share here:

Within the framework of the law it is a lawyer’s duty to ensure that the law is adhered to. If a prosecutor, for example, has traduced the law in order to convict someone, guilty or not, the accused must be accorded an appropriate defense. If a party is convicted through evidence that is obtained illegally, then that party, guilty or not, must be defended to the fullest extent, regardless of his or her lawyer’s moral beliefs about criminality.

During the last few weeks of my public health work as a psychiatrist here in New Zealand, I was consulted by someone who complained about a parent’s pressure upon her NOT to be jabbed by the Prizer so-called vaccine.

Given my public advocacy of early treatment, informed consent, and my explicitly voiced beliefs that covid jabs were both unnecessary and potentially dangerous, one might have expected that I would weigh in quite heavily in favor of the patient’s parental urging, with which, incidentally, I personally agreed.

I did not. In my role as a psychiatrist whose duty was to address the particular complaints of a patient within the context of her needs and wants, I suggested that the patient form her own decision about what or what not to take, and that she consult her GP.

Was it my duty, given my carefully formed assessment about the covid jabs and their risks, to persuade my patient against her own inclinations?

I certainly think not. I addressed the parental conflict, which was a priority, and encouraged her own adult independence, and encouraged her to inform herself.

Some may say that I was remiss. I would counter, first, that I could not in good faith and conscience step outside my area of expertise, and, second, that I could not insinuate with anything approaching certainty that the covid jab would WITHOUT DOUBT be detrimental. In fact, I know a number of the jabbed who seem perfectly healthy — which one may explain in a variety of ways, including mixed batches, time, chance, etc. It is not easy to draw a clear-cut line line between any medical intervention and an adverse event; it is notoriously difficult to establish causality, with any degree of certainty, for medical incidents or conditions generally.

I would argue further that had I sided with the patient’s parent and given strong advice not to partake of the jab I would probably have had nothing but a negative impact.

I believe I was a ‘good doctor’ for this patient. It is ironic that I was falsely accused of purveying anti-vax messages in my practice while working for New Zealand’s public health system. My public views were of course on display for anyone to hear; but in my private and singular capacity as a practitioner who geared interventions to a patient’s particular individualized needs, there was no place for my general pronouncements and opinions, however informed.

I can’t recall discussing the matter of vaccinations generally with any patients until covid hit. I routinely deferred issues about physical health to General Practitioners.

Was I a ‘good’ doctor, or a ‘bad’ one for not taking the opportunity to proselytize? Will I be held accountable for not attempting to ‘save’ someone from the jab?

I must note that to this day, now that I am retired, I am loath to push my views on anyone, because the central and fundamental crux remains our unalienable right to freedom— freedom of speech and freedom of choice and freedom from the coercive impositions of medical treatment of any kind.

I hark back often to the Parliament protests of 2022, galvanized to oppose the mandates that were foisted upon us. It was not an anti-jab protest, as some would like it to have been: it was anti-mandate.

My personal position is, at this point, strongly against most any vaccinations, based on what I have learned about them over these past several years. I was adamant early in 2020 that vaccinations were unnecessary to combat covid, and I hold that position today. Nonetheless, no matter how many young people may die suddenly, and no matter how many excess deaths there may be, most of the general public will disagree with me, and many will run to the pharmacies for their flu vaccines and covid boosters.

It’s their right to choose. Just as it is my right to speak out.

There are, of course, other characteristics that, to my mind, make a ‘good’ doctor, which include expert knowledge, and the ability to listen carefully and address an individual’s specific requirements. But that will be the subject for another essay on some other day.

Emanuel E. Garcia, M.D.

September 2024