Monday, March 24, 2008

Authority through Reticence

I'm reading The Great Mortality by John Kelly, a history of the Black Death plague and its impact on 14th century Europe.

Kelly describes a new code of demeanor and behaviour for medical practioners that emerged in the years before the plague arrived. It was essentially a set of 'Best Practices' for interacting with patients. For instance, the code instructed physicians, when in doubt of diagnosis, to prescribe a drug, any drug "that may do some good but you know can do no harm'. (the drug companies encourage this model to this day).

A key "don't" in the code was that the physician should not be too voluble with patients, but rather to maintain authority through reticence and professional distance. If the physician were to be overly chatty and informative, then not only would their authority over the patient be likely damaged, but they ran the risk of educating themselves out of a fee.

Things have changed.

And, ironically, it's now the customers of the authorities that may feel their business model is threatened.

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