The Practice of Medicine
The practice of medicine is an art as well as a science. For a long time now we have focussed on the science, and ignored the art.
Evidence-based medicine has been regarded as the ‘gold standard’ and we have been asked to apply it to all people and all cases.
But evidence-based medicine 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; when, having applied it, it is clearly not working for this particular person; and knowing that the evidence is limited to the physical, and that we are more than purely physical.
Indeed, there are cracks appearing in evidence-based medicine… it is increasingly being shown that some of the evidence is flawed, that studies are largely not repeatable; even then 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. The art of medicine is time honoured… listening to the patient, observing them, examining them as a whole in the context of work, family, community, society, all of which influence how we are.
Bringing this art together with true science – which itself is the art of observing things as they are, not as we would like them to be – offers us a way forward, to become true practitioners of medicine again.
By Dr Jane Barker and Dr Anne Malatt – Photography by Alan Johnston
Latest Articles on the Practice of Medicine
Reform is needed for unaccredited registrars
The plight of unaccredited registrars has recently been in the news here with the shocking story of a young female registrar who finally left...
Honouring the body we touch
Touch has been used in healing since ancient times. Touch can be a way of connecting with our patients, a way of expressing compassion....
Do doctors have post-traumatic stress from their training?
I woke early this morning, thinking about an article written by a young female surgeon (1) I had read recently, and I could not...
A knock on the door
30 years ago, a young doctor in overwhelm had planned to kill himself. He is now the President of a specialist College and wrote...
Trees as Teachers, Trees as Healers
We revere ancient trees, in awe of their size, their age, their beauty and the stories they may have told us if only they...
The joy of training medical students
I love training medical students; they bring me great joy.
Medicine is an apprenticeship system and the time-honoured approach of “see one, do one, teach...
New Year’s Resolutions – Let your Heart Lead the Way
The practice of Medicine is always a balance between head and heart, science and art, medical care and compassion. Sometimes our decision making, both...
The power of communication in medicine
Medicine has a language all of its own – a combination of Ancient Greek, Latin, people’s names, made-up words and acronyms – but what...
A Touching New York Story
This piece is a departure from my usual missives on physician health and suicide. I want to share an experience I’m sure many readers...
Bullying – time to say “No means NO”
Bullying is the antithesis of compassion; a way to break others down, to humiliate them and to challenge their sense of their own self-worth...
6000 signatures: doctors call for the release of children held in...
Many in the Australian medical profession would endorse the views of Dr Karen Phelps, GP, past president of the AMA and newly elected independent...
Violence against women: Dr Denis Mukwege and the Nobel Peace Prize
Medicine is a noble profession, so it is confirming and uplifting when we hear stories of those who have used the power of our...
Dr: Do two little letters define you?
Have you ever stopped to consider who you are or what defines you?Is your self-worth or self-esteem wrapped up in those two little letters...
Grace Under Pressure – Medicine in the Spotlight
Last night, together with our students and some staff we read the play Grace under Pressure. This is a powerful verbatim theatre work by...
The Nocebo Effect
I read an article (1) recently on the nocebo effect, which is the opposite of the placebo effect. When a person expects a side-effect...
The Power of Communication – It may Heal or Harm
In the past weeks many of us watched the real life drama of the cave rescue in Thailand. The International team, who had never...
Kindness Is in the Air
The title of this piece is a take on the airy and buoyant song of 1977, “Love Is in the Air.” Over the last...
Compassion, empathy and sympathy – what do they truly mean?
As a profession, medicine is beginning to be aware that we must care for the whole person, if we are to truly practise the...
The responsibility of our role as medical educators: Cows, coffee and...
I recently took part in a “rural taster”, an exercise in which medical educators and medical students spend time together in the country. Part...
Evidence Based Medicine and complementary therapies – can they work together?
Evidence based medicine and complementary therapies may seem uneasy bedfellows, but this does not mean we should not explore how they may be effectively...
Can the healthcare system become a compassionate workplace?
The idea of creating a “compassionate workplace” is currently popular and it is well worth us exploring in healthcare.
The Huffington Post reporting on the...
Evidence-based medicine: what is the evidence?
Medicine today prides itself on being evidence based, meaning that our practice is not random or whimsical, but scientific, based on treatments that have...
Are we teaching medicine upside down?
In many ways, the way we teach medicine is inside out and upside down! We meet our first patients tucked up under white sheets...
Dealing with the tension of being on call
I always found it really stressful to be on call for emergencies, until I learned a different way to deal with the tension of...
Whose role model are you?
We are all role models in life.
We watch each other, look to each other, for guidance when learning how to do things in life...
Pneumonia: the most lethal killer of children
Does medicine come with global responsibility? I believe that, at the very least, we should be willing to speak out against inequities in medical...
Examining our own reactions
Over the span of my career and in my own experience as a patient, on the receiving end of medicine, it has become more...
Being part of the ‘system’
We are all part of the ‘system’. In truth, we are part of several living systems, which form a complete and interconnected whole.
As doctors,...
First Do No Self-harm – The New “Physician’s Pledge”
Last week I met up with a newly graduated medical student whom I had mentored during his training. He had missed the award ceremony...
Let’s talk about energy
Albert Einstein is said to have said: “Everything is energy”.
If everything is energy, and it is, what part of that ‘everything’ does not include...