Saroj Misra, DO,
FACOFP; member, ACOFP Diversity, Equity and Inclusion Task Force; governor, ACOFP Board of Governors
Jul 22, 2021
Most of us at one time or another have heard of "The Golden Rule," the concept of treating others as you wish to be treated (or a similarly-phrased statement). This concept dates back to the earliest civilizations and religions of the world and has been identified as a basic ethical or moral tenet of most major faiths that exist today. So pervasive and essential is this idea that it was endorsed by 143 leaders of world faiths in 1993’s Declaration Toward a Global Ethic. Many of you reading this article probably learned this rule during your formative years—if not from your parents, then most likely from your teachers.
There is probably a good reason that most of us learn the Golden Rule when we are children—it serves as a simple way for us to think about respecting others using the only frame of reference we are capable of as youngsters: ourselves. As we grow and mature, however, we gain the capacity to ask questions, explore ideas and actively learn about other people in terms of their history, their experiences, their challenges and their triumphs. Importantly, we can develop the capacity to recognize that others’ values may be different from ours because of the way life has shaped them. Considering this growth pattern, it becomes far clearer that the Golden Rule’s biggest challenge is the assumption that others around us are just like us—that the people we interact with (be they patients, peers or society in general) have had similar upbringing, life experiences and challenges to us. The Golden Rule implies that what we value will be what others value as well. As has become increasingly evident and publicized over the last two decades, the experiences of people in this country have been and continue to be incredibly diverse, resulting in a diverse population where people may value different things and hold different ideas about what it means to be treated with respect or valued within society.
We need a better approach—one that recognizes that people’s experiences, beliefs and values are not only potentially different but are worthy of respect. In his book, The Art of People, Dale Kerpen suggests that following the Golden Rule is ok, but following the "Platinum Rule" is much better. The Platinum Rule says, "Treat others as they want to be treated." In this way, we focus on the needs of the individual and we do so through their lens, rather than through ours. The Platinum Rule can be applied in many ways in our personal and professional lives.
As physicians, we often use our own lens of experience to approach how we make treatment decisions; we don’t always take into account how the patient’s background and values might impact the choices we offer and make in delivering care. When we apply the Platinum Rule, we start to be more focused on what the patient needs in the way they need it. Sometimes, we apply the rule without even thinking about it. For example, I became much more savvy about anticipating reactions to my parenting suggestions after I had children of my own—and more empathetic too! Always pay attention to your patients’ experiences and use them to inform how you counsel others; recognize that if you apply the Platinum Rule, you can learn from patients as well as teach them.
Most physicians are leaders in some fashion in their careers—within offices, health care systems, professional societies and community organizations. Applying the Platinum Rule in how we lead others is effective in ensuring that people feel engaged and valued. In addition, using the Platinum Rule helps leaders to identify and address micro-aggressions—"The everyday slights, indignities, put downs and insults that people of color, women, LGBT populations or those who are marginalized experiences in their day-to-day interactions with people," as defined by psychologist Derald Sue—that may be occurring but are not recognized. If we apply the Platinum Rule, instead of saying "I wouldn’t care if they said or asked that" or "What’s the big deal? It doesn’t bother me," we end up saying "This hurts these individuals, so I’ll be more respectful of that fact."
Many traditionalists might see the Platinum Rule as just being "politically correct." As physicians, I would suggest that applying the Platinum Rule has nothing to do with politics or correctness. It is all about recognizing the need to value people the way they wish to be valued. In this way, it is not unlike Sir William Osler’s famous quote: “The good physician treats the disease; the great physician treats the patient.” Our profession is all about treating the patient—and the Platinum Rule reminds us to do so in a way he or she will value.
There is probably a good reason that most of us learn the Golden Rule when we are children—it serves as a simple way for us to think about respecting others using the only frame of reference we are capable of as youngsters: ourselves. As we grow and mature, however, we gain the capacity to ask questions, explore ideas and actively learn about other people in terms of their history, their experiences, their challenges and their triumphs. Importantly, we can develop the capacity to recognize that others’ values may be different from ours because of the way life has shaped them. Considering this growth pattern, it becomes far clearer that the Golden Rule’s biggest challenge is the assumption that others around us are just like us—that the people we interact with (be they patients, peers or society in general) have had similar upbringing, life experiences and challenges to us. The Golden Rule implies that what we value will be what others value as well. As has become increasingly evident and publicized over the last two decades, the experiences of people in this country have been and continue to be incredibly diverse, resulting in a diverse population where people may value different things and hold different ideas about what it means to be treated with respect or valued within society.
We need a better approach—one that recognizes that people’s experiences, beliefs and values are not only potentially different but are worthy of respect. In his book, The Art of People, Dale Kerpen suggests that following the Golden Rule is ok, but following the "Platinum Rule" is much better. The Platinum Rule says, "Treat others as they want to be treated." In this way, we focus on the needs of the individual and we do so through their lens, rather than through ours. The Platinum Rule can be applied in many ways in our personal and professional lives.
As physicians, we often use our own lens of experience to approach how we make treatment decisions; we don’t always take into account how the patient’s background and values might impact the choices we offer and make in delivering care. When we apply the Platinum Rule, we start to be more focused on what the patient needs in the way they need it. Sometimes, we apply the rule without even thinking about it. For example, I became much more savvy about anticipating reactions to my parenting suggestions after I had children of my own—and more empathetic too! Always pay attention to your patients’ experiences and use them to inform how you counsel others; recognize that if you apply the Platinum Rule, you can learn from patients as well as teach them.
Most physicians are leaders in some fashion in their careers—within offices, health care systems, professional societies and community organizations. Applying the Platinum Rule in how we lead others is effective in ensuring that people feel engaged and valued. In addition, using the Platinum Rule helps leaders to identify and address micro-aggressions—"The everyday slights, indignities, put downs and insults that people of color, women, LGBT populations or those who are marginalized experiences in their day-to-day interactions with people," as defined by psychologist Derald Sue—that may be occurring but are not recognized. If we apply the Platinum Rule, instead of saying "I wouldn’t care if they said or asked that" or "What’s the big deal? It doesn’t bother me," we end up saying "This hurts these individuals, so I’ll be more respectful of that fact."
Many traditionalists might see the Platinum Rule as just being "politically correct." As physicians, I would suggest that applying the Platinum Rule has nothing to do with politics or correctness. It is all about recognizing the need to value people the way they wish to be valued. In this way, it is not unlike Sir William Osler’s famous quote: “The good physician treats the disease; the great physician treats the patient.” Our profession is all about treating the patient—and the Platinum Rule reminds us to do so in a way he or she will value.
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