The basis of trust is individual credibility. This is based on factors such as integrity, intent, skills\u00a0and results, which are linked together like the parts of a tree. Integrity and intent are to do with\u00a0character, while the other two concern competencies. Prof. Peter Vajkoczy is a famous German\u00a0neurosurgeon who also carries out research in the field of neurosurgery. Talking to him about trust\u00a0in terms of these four factors also involves his professional domain and the findings that have\u00a0emerged.<\/p>\n
Christian Bracht: Trust is something you have to work hard over a long period of time to earn. In\u00a0today\u2019s society we\u2019re seeing a decline in trust with regard to institutions, politics and the media, but\u00a0not with regard to doctors. How do you explain that?<\/p>\n
Prof. Peter Vajkoczy: I too am just a normal citizen observing what is happening around me. Only\u00a0yesterday I asked myself why politicians are so unsatisfactory at communicating certain issues to\u00a0people. My answer is that it\u2019s a result of too much short-term thinking. I think people sense short-termism in decision-making and opportunism with regard to certain issues. But trust is always a\u00a0long-term matter and a long-term promise. It builds on character traits, competence, experience and\u00a0results that have been achieved.<\/p>\n
CB: And I would say that integrity plays a significant role and is responsible for doctors being\u00a0trusted.<\/p>\n
PV: I would attribute a lot more to the zeitgeist and the speed with which things are changing and\u00a0also the need to please the masses. That\u2019s not something you can build on over the long term. If\u00a0circumstances change quickly, or if a decision was wrong and is then changed, this creates mistrust.<\/p>\n
CB: It\u2019s not only trust in institutions that has declined, but trust in the role of the media too. Doesn\u2019t\u00a0that affect us?<\/p>\n
PV: I don\u2019t think trust has lost anything in terms of its value. We\u2019re continually being flooded with\u00a0a great deal of information and that\u2019s where a certain amount of paranoia can arise. This makes us\u00a0ill, because at some point we no longer know which side we\u2019re on, or we can no longer tell right\u00a0from wrong. This inability and difficulty in creating an informed picture for oneself, coupled with\u00a0the feeling of being manipulated, creates a high level of mistrust. This can then go so far as to make\u00a0your lose your compass sometimes \u2013 and that comes very close to a fundamental loss of trust.<\/p>\n
CB: But then how can I restore order?<\/p>\n
PV: Everything has become increasingly dynamic and the half-life of information or news has\u00a0changed. We\u2019ve become inured to scandal to an extent and also very quickly forget. Our mentality\u00a0is one of stimulation and repression. I think in order to restore order, you need a lot of trust in\u00a0yourself.<\/p>\n
CB: Let\u2019s go back to trust in doctors and the medical profession in general.<\/p>\n
PV: Actually, doctors have often aroused mistrust. When we talk about unnecessary operations or\u00a0payments, a different picture often emerges. During the pandemic, however, society understood the\u00a0importance of health and good healthcare. Doctors generally have a positive impact and were able\u00a0to build trust through the pandemic. I believe that the profession conveys a certain degree of\u00a0seriousness and that there is a certain level of trust in it. As I said, trust can also be betrayed, but it\u2019s\u00a0nice that we have this little bonus at least.<\/p>\n
CB: Trust is also to do with transparency. You often have to give patients quite brutal information\u00a0in a very direct way.<\/p>\n
PV: Do I? I think that sensitivity and a sense of what information the other person would like to\u00a0hear are paramount. And when we talk about trust, the level of trust between doctor and patient and\u00a0vice versa is crucial. You have to work on it and the chemistry between the two has to be right. One\u00a0secret is that the doctor gets a sense of how far he or she can go and how far it is reasonable. Of\u00a0course, if you\u2019re frank about things you also lose a certain degree of hope. Medicine isn\u2019t a one-hundred-per-cent discipline, and biology certainly isn\u2019t, and that\u2019s why it\u2019s sometimes difficult to\u00a0have such an absolutist opinion. You have to be open and transparent, and it\u2019s important to be\u00a0honest up front in your assessment of the possibilities. I\u2019m sure people appreciate that honesty.<\/p>\n
CB: And what about ethical principles?<\/p>\n
PV: I think it\u2019s much more important that you represent traditional values, that you have humility\u00a0and maybe also a sense of values. People are really looking for this again, which brings us back to\u00a0the notion of a compass.<\/p>\n
CB: And empathy!?<\/p>\n
PV: Empathy plays a very important role in the medical profession. You learn medicine in medical\u00a0school. It\u2019s learning by doing. You have to find your own style. I choose my young colleagues\u00a0accordingly. They can all learn the technical side, but it\u2019s hard to learn what\u2019s valuable. That\u2019s not\u00a0something you\u2019re born with. Our individual socialisation and family teach us how to be as human\u00a0beings. And that can be seen, for example, in how you talk with patients, and if you don\u2019t hide\u00a0yourself away in the face of complications, but seek out dialogue instead.<\/p>\n
CB: And what about your personal sense of trust?<\/p>\n
PV: I trust people who have worked with me and known me for a long time, such as my wife and\u00a0friends. I trust my mentors, of whom I have four or five, because they give you their frank opinion.\u00a0I think there are a handful of people in life that you really confide in. And I have trust in our\u00a0healthcare system, even if there\u2019s still a lot of room for improvement.<\/p>\n