The Practice of Medicine

The practice of medicine is an art as well as a science. For a long time now we have largely focussed on the science, and ignored the art, at the great expense of people, including ourselves.

Medicine used to care for the whole person, but our focus has been progressively reduced, and we have become more and more focussed on the parts, sometimes at the expense of the whole.

Evidence-based medicine has come to be regarded and taught as the ‘gold standard’ of practice and we have been asked to apply it to all people and all cases.

Evidence-based medicine has an important role to play in our practice, but it is based on population studies, and while it may give us a big picture on which to base our decisions, it does not apply in every single case. Indeed, applying it indiscriminately can cause great harm, for people are unique individuals, who do not always fit into evidence-based sized boxes.

This is the art of medicine – knowing when to apply the evidence; knowing when, having applied it, it is clearly not working for this particular person and a different approach is called for; and knowing that the evidence is often limited to the physical, when we are more than merely physical.

Indeed, there are cracks appearing in evidence-based medicine. It is increasingly being shown that some, if not much of the evidence is flawed, that studies are often not repeatable; even that studies have been corrupted because of the vested interests of those paying for the research.

Evidence-based medicine is important, but it is not everything in its current form, because it largely ignores the evidence of the body and the being inside the body. The art of medicine is time honoured … listening to our patients, observing them, examining them as a whole in the context of work, family, community, society, all of which can influence health and wellbeing.

Bringing this art together with true science – which includes the art of observing things as they truly are, not as we would like them to be – offers us a way forward, to become true practitioners of medicine again.

The Pill

Dr Anne Malatt - November 22, 2021 2

Of all the many drugs on the market, there is only one pill known as ‘The Pill’. The Pill is a combination of synthetic female hormones – oestrogen and progesterone – used to mimic pregnancy and suppress female ovulation and thereby fertility, reducing the chance of unwanted pregnancy.

Making the choice

A Doctor's Wife - November 14, 2021 0

My experience so far with medical specialist training programmes and making the choice about which one to do, reminds me of the journey Frodo takes in the Lord of the Rings movie.

Photo of Dr Michael Myers for article by Dr Michael Myers

National Physician Suicide Awareness Day 2021: With Gratitude to the Feists

Dr Michael Myers - October 21, 2021 0

A beautiful blog by Dr Michael Myers, on the recent National Physician Suicide Awareness Day and the great work being done by Jennifer and Corey Feist, founders of the Dr Lorna Breen Heroes Foundation, one of the missions of which is “We envision a world where seeking mental health services is universally viewed as a sign of strength for health care professionals.”.

True Resilience

Dr Anne Malatt - September 29, 2021 2

The key to developing true resilience is to care for ourselves and restore our sense of innate wholeness and worth, learning to love and appreciate ourselves just for who we are and to honour our innate sensitivity, letting the wisdom of our body guide our way, each and every day.

A Wellbeing Charter for Doctors

Dr Anne Malatt - September 17, 2021 1

The Royal Australasian College of Surgeons (RACS) in conjunction with several other medical colleges and more to come, has just released a Wellbeing Charter for Doctors. This is a great first step in acknowledging the importance of self-care in healthcare professionals and the need for this care to be a shared responsibility for all of us.

Standards

Dr Anne Malatt - September 5, 2021 4

We all have standards. They may not always be the same standards, but we all have them. Values that we hold dear, points of truth we will not compromise, a way of living that we hold as sacred.

Invoking Caste: Why Physicians With Psychiatric Illness Are Shunned

Dr Michael Myers - August 25, 2021 2

American medicine has a checkered history in its welcoming of physicians who are black, women, physically disabled, LGBT, to name a few. As a specialist in physician health and a 50-year career of treating physicians,1 I would like to add another group that has struggled for acceptance—physicians who have suffered a psychiatric illness. I argue that caste may be the reason.

It Is Never Too Late

Dr Michael Myers - June 6, 2021 0

My name is Evan Haines*. I’m writing you because I believe my mother, who, sadly, committed suicide in 1989, was under your care. I remember your name, and that she always thought very highly of you.

How Well-Intentioned Advice Is Suppressing the Doctors of Tomorrow

Dr Michael Myers - April 23, 2021 2

Read this blog by renowned psychiatrist Dr Michael Myers on how well-intentioned advice is suppressing the doctors of tomorrow

A Tip of the Hat to Medical School Applicants: Chipping Away at Stigma

Dr Michael Myers - April 16, 2021 2

One dimension of my daily work that I really enjoy is interviewing applicants to medical school. I’m often tasked with interviewing a specific group of applicants, the ones who openly write that they have suffered from mental health symptoms in the past.

Personal sustainability

Dr Anne Malatt - April 7, 2021 1

We hear a lot about sustainability these days in terms of the economy, the environment, and society, but what is personal sustainability when it comes to us, the people who make up that society and determine what sustainability is?

Picture of human heart by Leonardo da Vinci for article by Dr Fiona Williams on Heart-centred Medicine

Heart-Centred Medicine: A Return to Ancient Wisdom

Dr Fiona Williams - January 1, 2021 0

Would a return to an ‘innermost’ way of life, a heart-centred intelligence and awareness, be something we as physicians, could consider?

Dr. Michael Myers on Becoming a Doctors’ Doctor

Dr Michael Myers - December 11, 2020 6

In this podcast, Michael Myers, MD, and John Budin, MD, discuss Dr. Myers' recent book Becoming a Doctors' Doctor: A Memoir, as well as how the COVID-19 pandemic is helping medical professionals admit their vulnerabilities and steps clinicians can take when they have colleagues who may need professional help.

photo of woman in mask for article on masks by Dr Fiona Williams

Masks: are you wearing one?

Dr Fiona Williams - November 20, 2020 4

It’s 2020. The Year of the Mask. Whether you are a medical professional or not, you will have been asked to wear them, discern their worth, determine which type is best for you, consider their real purpose and deliberate on where you stand with respect to the health benefits they may offer you personally or the population as a whole.

Photo of pink rose for article by 'A Doctor's' Wife'

Diary of a Doctor’s Wife

A Doctor's Wife - November 11, 2020 1

These moments have taught me to become adaptable and go with the flow. My own solid rhythm is paramount these days, otherwise disappointment and frustration come knocking. Trust me, I have tried to control it and wanted it to be another way and it doesn’t work.

Remembering Dr. Lorna Breen on National Physician Suicide Awareness Day

Dr Michael Myers - October 21, 2020 0

September 17, 2020, marked the third annual National Physician Suicide Awareness Day. This is a day to remember physicians who have taken their own lives.

Lighthouse

A Doctor's Wife - October 8, 2020 0

We are each and every one of us a lighthouse, designed to shine bright and light the way for others. It is for us to let that light out and shine in full, reminding everyone we meet that they too are that light, for this light lives inside us all, and we are all here to shine and light the way home together.