Trust Me, I’m a Doctor…

Joan Tumblety has recently published an article in the Lancet exploring the history of medical lobbying (follow the link here to read more). Here she explores some of the key questions that she has about this topic:

Trust me, I’m a doctor….

If we laugh at this popular phrase, what is the truth we are recognising?
In my research, I have become increasingly interested in the problem of what might be called the cultural overreach of physicians. What piqued this interest was my research into the get-fit gurus of early twentieth-century France, which made me realise how common it was for trained doctors to plug their services to members of the general public on the grounds of their medical expertise. Some of them just wrote popular advice literature about fitness, healthy living and how to ‘stay young’ alongside their day job. But others crossed wholesale from professional practice to the world of leisure and popular culture, trading on their medical credentials in a new context altogether. Was this warranted, I asked myself?

On the one hand, the physicians who went into business for themselves as gym operators and personal trainers (not that they put it quite like that at the time) can be understood as early practitioners of sports medicine or preventative health. I am minded of the light-hearted ‘Life. Be in it.’ television advertising campaign, familiar from my Australian childhood, which followed the lifestyle of the overweight, beer-guzzling cartoon character ‘Norm’, as he was prised off his couch and into physical activity, all part of a public health campaign to combat obesity and thus guard against heart disease, stroke and diabetes. Why wouldn’t the medical training of my get-fit gurus, with their knowledge of anatomy and physiology, make them legitimate purveyors of physical fitness?

What troubled me was that these individuals usually made cultural claims in their work as well as medical ones, and they often mobilised prevailing ideas about beauty and gender in their quest to win over new clients, setting themselves up as experts on the moral failings of the ‘ugly’, armed with the right to lecture women about their social obligations to be decorative, and to instruct men in their choice of marriage partner. Some of them were overtly eugenicist in their drive to improve the ‘breeding stock’ of the French ‘race’. This struck me as a different kind of cross-over activity than that involved in moving professional discipline, and one that seemed far less legitimate.

It was to explore further this interest in the cultural work of physicians that I teamed up with the historian of medicine and legal scholar Dr Catherine Kelly. This involved putting my ideas into a much wider context, thinking about the diverse ways in which physicians (and surgeons too) had sought out ways of influencing the societies in which they lived. Together we organised an international workshop in 2015 on the question of how medical professionals, from the late eighteenth century to the present, operating in the British and French metropolitan and colonial worlds, became involved in the lobbying of parliamentarians in order to shape the laws that govern ‘public health’, a catchall term that encompassed—among other things—sanitation, quarantine and vaccination, the use of lead in paint, food hygiene and wet-nursing. We published a short piece on this theme in The Lancet in October 2016, pointing in fact to the positive effects on collective well-being of the intervention of trained physicians in the parliamentary realm.

Underneath the specificities of the historical case studies lay common concerns and patterns that pointed to the significance of the cultural dimension of this work. All doctors had to think carefully about what strategies and techniques might be the most effective in persuading their chosen audience, thus convincing their fellow professionals, their elected political representatives or the general public of their authority to pronounce on these matters. In addition to argumentative skill, it helped if doctors in general were seen as cultural trustworthy figures. That status was and is elusive, and not entirely in the gift of medical professionals themselves to achieve. The idea of how this cultural authority is created, how it operates, and to what effect, is one of the central problems that I’m exploring in my current research projects on physician-writers, and on the presentation of science and medicine to the public in 1930s France.

To return to my opening question, I think that when we laugh at the commonly deployed phrase, ‘trust me, I’m a doctor’, we are recognising the power of this cultural authority. But we are also acknowledging a common suspicion of it, the possibility that such authority can be assumed and exerted in unwarranted ways.