Cynicism as a strategic virtue.

Abstract

Doctors are often forced to negotiate between imperatives of policy and the demands of good practice. Cynicism arises in the welter of difficult feelings elicited by such contexts, and is widely assumed to be bad for patients, national health systems, and for the clinicians themselves. Cynicism is typically regarded as a cause of distrust, professional misconduct, and a pathway to burnout. It is true that untempered cynicism can have these consequences. However, much of the cynicism seen in contemporary health care is not untempered, nor is it simply negative or unprofessional behaviour. Rather than simply the shrivelled hope of good practice, we argue that more balanced forms of cynicism can support rather than undermine quality of care.