The ‘good psychiatrist’ standard according to Antoni Kępiński. Examples from the decisions of medical disciplinary boards

Abstract

Purpose: To present the physician’s work ethic of Professor Antoni Kępiński, who, throughout his professional life, emphasized the importance of a sincere, accepting and non-judgemental approach to the patient. This was the only relationship capable, in Professor Kępiński’s opinion, of enabling the practitioner to know the patient and provide successful therapy. Do modern psychiatrists follow this concept? In practice a question arises about the current shape of the psychiatrist-patient relationship and what the relationship should look like. Views: In his numerous publications Antoni Kępiński lists errors made by psychiatrists while diagnosing and treating patients with mental disorders. Such errors can be divided into three groups: the ‘object’ error (the doctor is not treating the patient as a subject but rather as an object, their relationship is not partner-like), the ‘mask’ error (the adoption of an artificial pose that is at odds with the physician’s current actual psychic experience), and the ‘judge’ error (the doctor is judging the patient). Conclusions: Analysis of sample decisions from Regional Medical Disciplinary Boards (okręgowy sąd lekarski — OSL — ‘regional medical court’), and the Supreme Medical Disciplinary Board (Naczelny Sąd Lekarski — NSL — ‘Supreme Medical Court’) involving psychiatrists shows behaviours inconsistent with Professor Kępiński’s high ideals. Errors result mainly from a lack of ability to take a holistic view of the patient and establish appropriate contact with them as a human being. Hence, there is a need to develop the skill of doctor-patient conversation early on, in specialization training, and later throughout the psychiatrist’s entire professional life.