When Judgement Becomes Emotional Reaction

Healthy Scepticism Matters

Doctors are trained to question evidence, manage risk and protect patients. These responsibilities sit at the heart of good clinical practice and explain why many clinicians approach the pharmaceutical industry with a healthy degree of scepticism.

Most of the time, that scepticism serves patients well. It encourages careful thinking, robust discussion and evidence-based decision making.

Problems arise, however, when scepticism stops being a process of enquiry and becomes a settled assumption. Instead of examining the evidence, conclusions are reached before the evidence has been considered. Professional judgement begins to give way to emotional reaction, often without anyone recognising that the shift has taken place.

Looking from Both Sides

For more than ten years I worked as a pharmaceutical representative in London’s teaching hospitals. That experience gave me the opportunity to observe relationships between clinicians and the pharmaceutical industry from both sides.

I witnessed poor practice within medicine and within the pharmaceutical industry. I also worked alongside doctors and pharmaceutical professionals whose integrity, knowledge and commitment to patient care were beyond question. Those experiences taught me that broad generalisations rarely reflect reality.

Public discussion often concentrates on pharmaceutical companies as organisations. Much less attention is given to the individuals who work within them. Yet many pharmaceutical representatives spend their careers supporting healthcare professionals by providing accurate clinical information, answering questions and helping clinicians stay informed about developments relevant to their practice.

The best representatives understand that trust cannot be expected. It has to be earned. They know that credibility depends upon accuracy, honesty and respect for clinical independence. Their role is not to persuade clinicians to make particular decisions. Their role is to contribute information that helps clinicians make informed decisions for themselves.

Emotional Intelligence in Professional Practice

This is where emotional intelligence becomes particularly important.

Experienced representatives understand how they may be perceived and adapt their approach accordingly. They recognise when to explain, when to listen and when to step back. They appreciate the pressures clinicians face and understand that every discussion takes place within the wider context of patient care, limited time and increasing professional demands.

When these qualities are present, conversations become more productive. Trust develops gradually, allowing research findings, clinical experience and practical questions to be explored openly. Relationships become professional partnerships built upon mutual respect rather than commercial transactions driven by competing interests.

How Bias Shapes Professional Judgement

Human beings rarely make decisions free from bias. We all rely upon mental shortcuts that help us interpret complex situations quickly.

Confirmation bias encourages us to notice evidence that supports beliefs we already hold while overlooking evidence that challenges them. Memorable negative experiences often carry greater weight than many routine positive ones. Professional identity can also create an unconscious distinction between those we see as being on our side and those we regard with greater suspicion. Attribution bias then encourages us to assume motives before we have examined behaviour objectively.

None of these psychological processes are unique to doctors. They influence every profession.

The difference is that medical opinion carries considerable authority. Patients, colleagues and the wider public rightly place enormous trust in clinical judgement. That makes it even more important for clinicians, like all professionals, to remain aware of how unconscious bias can influence their thinking.

When Assumptions Replace Curiosity

During my career I occasionally noticed conversations change in subtle but significant ways.

A discussion that began professionally would suddenly become less about understanding and more about challenging. Questions were asked to expose weaknesses rather than explore evidence. Information was dismissed because of where it came from rather than because of its quality. Motives were assumed before they had been demonstrated.

These moments were sometimes hostile. They were often brief and almost invisible to those involved. Yet they revealed something important. The conversation was no longer being guided solely by critical thinking. Assumptions had quietly begun to shape the outcome.

That distinction matters. Critical thinking examines evidence before reaching conclusions. Bias reaches conclusions before examining evidence.

Why It Matters

The consequences extend beyond individual conversations.

When discussions close down too quickly, opportunities to explore new evidence may be lost. Professional relationships become more cautious than collaborative. Respect between clinicians and pharmaceutical professionals can gradually erode, even though both groups ultimately share the same objective of improving patient care.

At the same time, the conversation is rarely balanced. Doctors have a respected public voice, and rightly so. Pharmaceutical representatives are heard far less often and are frequently judged according to assumptions about the industry rather than by their own professionalism or conduct.

Recognising this imbalance does not require anyone to lower their professional standards. Healthy scepticism remains essential. Every claim should continue to be examined carefully and every piece of evidence evaluated on its merits.

What deserves greater scrutiny is not scepticism itself, but the point at which scepticism hardens into certainty before the evidence has been considered.

Professional Judgement Requires Emotional Intelligence

Good professional judgement depends upon more than knowledge and technical expertise. It also depends upon self-awareness, curiosity and the willingness to question our own assumptions.

Throughout my career I have met pharmaceutical representatives who demonstrated exceptional professionalism, respected clinical independence and genuinely wanted to contribute to better patient outcomes.  I have also met clinicians close down  a conversation too quickly, judge too broadly and communicate less effectively than they might realise.

I have also encountered occasions where assumptions replaced enquiry on both sides.

Neither profession has a monopoly on good practice or poor practice. Both are made up of individuals whose behaviour ranges from exemplary to disappointing.

The strongest professional relationships are built when people judge one another by the quality of their evidence, the integrity of their conduct and the respect they show for others, rather than by the labels attached to their profession.

Doctors and the pharmaceutical industry will always have different responsibilities. They should. Those differences provide valuable checks and balances within healthcare.

What they should not become is a reason to stop listening.

Professional judgement is at its best when it remains open-minded, evidence-based and willing to challenge its own assumptions. Emotional intelligence makes that possible. It helps us recognise when thoughtful scepticism is quietly becoming emotional reaction, and it reminds us that the best decisions are made not by defending our beliefs, but by remaining willing to examine them.