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.

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Latest Articles on the Practice of Medicine

AJ Held dawn 23 July 2021 for article by Dr Anne Malatt on a Wellbeing Charter for Doctors

A Wellbeing Charter for Doctors

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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.
pale pink rose in Virgo 20 for article by Dr Anne Malatt on Standards

Standards

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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.
Photo of Dr Michael Myers for article by Dr Michael Myers

Invoking Caste: Why Physicians With Psychiatric Illness Are Shunned

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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.
Photo of Dr Michael Myers for article by Dr Michael Myers

It Is Never Too Late

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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.
Photo of Dr Michael Myers for article by Dr Michael Myers

How Well-Intentioned Advice Is Suppressing the Doctors of Tomorrow

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

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

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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.
water lily for article on personal sustainability by Dr Anne Malatt

Personal sustainability

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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

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Would a return to an ‘innermost’ way of life, a heart-centred intelligence and awareness, be something we as physicians, could consider?
Photo of Dr Michael Myers for article by Dr Michael Myers

Dr. Michael Myers on Becoming a Doctors’ Doctor

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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?

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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

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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.
Photo of Dr Michael Myers for article by Dr Michael Myers

Remembering Dr. Lorna Breen on National Physician Suicide Awareness Day

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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.
Photo of lighthouse for article by a doctor's wife called Lighthouse

Lighthouse

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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.
Photo of Dr Michael Myers for article by Dr Michael Myers

Giving Physicians a Private Place to Turn

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For several months, I have been following news about the Physician Support Line launched by Dr. Mona Masood, a Philadelphia psychiatrist (1,2). As a...
Photo of Anne Malatt and Paul Moses for article by Paul Moses on Being Married to a Doctor

Being married to a doctor

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What is it like, being married to a doctor? My gorgeous wife is an eye surgeon; we have been together for 16 years and...
Photo of pink rose for article by 'A Doctor's' Wife'

A Dance

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My husband often works at the hospital at night and so as the saying goes, we are two ships passing, living a dance where...
Photo of sunflower for article by Dr Pseudonymous

Age is no barrier to medicine

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I have come to medicine later in life.  I was 32 when the impulse to study medicine came, 34 when I sat the entrance...
Photo of pink rose for article by 'A Doctor's' Wife'

Coronavirus and contagion: what are we passing on?

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My husband works as a doctor in a hospital so I am frequently reminded of the constant demand health professionals are under. On a...
image of washing hands for article on Coronavirus by Dr Anne Malatt

Coronavirus: isolate physically, but don’t socially isolate 

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We are in the midst of a coronavirus pandemic, and being told to socially isolate if we have travelled overseas recently, been in contact...
Photo of pink rose for article by 'A Doctor's' Wife'

A Doctor’s Wife

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I met a beautiful man several years ago and we fell in love instantly. He was not working as a doctor when we met...
Photo of red rose for article by Dr Anne Malatt on Why Bring Love into Medicine?

Why bring love into medicine?

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The words love and medicine are rarely used in the same sentence. Not many people say they love taking their medicine. Not many doctors...
Photo of newborn baby for article by Dr Anne Malat called 'This is going to hurt'

This is Going to Hurt

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One of the joys of having a Christmas/New Year break is having the time and space to read. I recently read a book called:...
Photo of Dr Michael Myers for article by Dr Michael Myers

Harnessing Grief Into Action: A Tribute to a Remarkable Woman

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Dr. Sangeeta Mahajan is a remarkable woman. She is a consultant anesthetist at Guy’s and St Thomas’ NHS Foundation Trust in London, England. She...
Photo of sunflower for article by Dr Pseudonymous

Mentors, Sponsors and Gender Inequity

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I recently attended a conference and heard a presentation delivered to female surgeons which addressed the subject of mentors, sponsors and gender inequity in...
Photo of Anne Malatt in her blue Porsche for article by Dr Anne Malatt on Enriching Life

From being bored to enriching life

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I work as an eye doctor and people sometimes ask me: Don’t you get bored with what you do? Well the answer is: No,...
photo of rose by Anne Malatt for article by Dr Anne Malatt on why do patients withhold information from their doctors

Why half our patients don’t tell their doctors life-threatening details

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I recently read an article stating that nearly half of patients who were surveyed online admitted they don’t tell doctors potentially life-threatening details of...
Photo of Dr Eunice Minford for article by Dr Eunice Minford on The Fragmentation of Medicine

The Fragmentation of Medicine

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I have witnessed many changes within medicine over the last 30 years – one of which has been the increasing fragmentation of medicine despite...
Photo of Dr Michael Myers for article by Dr Michael Myers on physician suicide awareness day

The Key to Orienting Incoming Residents and Fellows

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I recently had a chance to speak to State University of New York (SUNY) Downstate’s incoming residents and fellows about well-being and self-care.These women...
Image of space for article by Dr Anne Malatt 'Are you trapped in time or surrendered to space?'

Are you trapped in time, or surrendered to space?

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I used to live life ruled by time. I was not a very obedient subject, and was always running late, but it ruled me,...
Photo of Dr Eunice Minford for article 'Falling in and out of love with Medicine"

Falling in and out of love with medicine

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I loved studying medicine as a medical student. I was so curious to know how the body worked – how this bit interacted with...