Making "Referrals"

I still remember one of my friends who worked in Taiwan, and in their note (shared desensitized and anonymously), the patient is not following doctor's instructions, so that person asks if the patient needs referral to the Audiology Dept. My friend faithfully documented this conversation in their note. It was quite funny, to be honest, but I can feel the frustration and humiliation my friend had suffered. 

Clients may not be able to follow instructions due to reality concerns, like bills (as mentioned by Mechanic & Schlesinger, 1996) and work-life imbalance. Notwithstanding these concerns, there are deeper emotional reasons. Goold's article (2002) discussed several reasons regarding the client-professional tension. Firstly, the clients have no choice but to grant the professionals with trust, since they are the more vulnerable party, which is actually well-mentioned and discussed under the code of ethics in my Psychology training. Even well-meaning professionals can lose sight of the privilege they carry into every client interaction. As the article mentioned, that "discretionary power" is granted to the professional for the sake of fulfilling the clients' desires. The clients have no choice but to surrender their body and sensitive information to the professionals. 

Goold's article (2002) also argues that perceptions, beliefs and expectations are key components in a trusting relationship. Such a concept can be testified by cases surrounding me, like a person I know was forced to drink "charmed water" pleaded by their parents from nowhere to cure the skin diseases. Taher et al.'s article (2020) mentioned how much of the population still holds superstitious beliefs that actually damages advancement in medical practices, and psychologically, the superstitious ideas actually exert a sense of control. Dealing with this concept can be challenging, as the fact that few definitions have been made in the nursing field.

Goold's article (2002) discussed how some of the thought processes a professional conducted can be processed so fast and discreetly, and failed to be conveyed to the clients properly undoubtedly. When the clients failed to receive and process the decision making process, distrust can arise. Interestingly, not disclosing the professionals' payment or medical error increases the clients' trust. Such an untrustworthy behaviour actually increases the trust from the clients. This phenomenon actually reveals how different parties build trusts in different ways. 

When I visited the hospital, I saw a poster that informed me some medical info was leaked. I am aware that as the law requires, disclosing the incident is part of the SOP, but people with less of the knowledge in the field may consider it differently–providing such info to the public seems unnecessary, and can be interpreted as supplicating while condescending. 

My deeper reflection of this topic is probably about meritocracy, that few people decide what is the best for the clients, either due to the lack of voting power or simply because they are not in the room (or worse, an systemic exclusion from the decision-making process altogether) when decisions are made. The statutory and regulatory bodies serve as the medication between the two parties. On one hand, the regulatory bodies serve as the guardian of professionalism and the protector of the public, while on the other hand, those bodies may fail to be held responsible for the concerns the professionals have (Mannion et al., 2025), which is the wonder of a system: when the obligation comes, accountability diffuses across its layers until no single body remains answerable. Mannion et al., (2025) also warns people how it may damage workers' mental health due to lack of guidance and support.

Not all truth needs to be shared, but all the truth needs to be acknowledged. It's also OK to just rant in the comment, as long as no real name and address is mentioned. Be sure to not judge others when you try to reply to others. "Not to judge" means:

• No dismissing or belittling opinions.
• No making assumptions about intention.
• No condescending language.
• No giving unsolicited criticism and suggestions.
• No mocking or sarcasm at someone's expense.
• No labelling or stereotyping.
• No "misery competition" or "pain Olympics."

Hope you folks to have a nice day ! 

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