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

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Personal sustainability

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Heart-Centred Medicine: A Return to Ancient Wisdom

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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.  
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Masks: are you wearing one?

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Lighthouse

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Coronavirus: isolate physically, but don’t socially isolate 

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The Contagion of Fear – the Coronavirus Pandemic and Medicine

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This is Going to Hurt

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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...
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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,...
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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...
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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...
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Falling in and out of love with medicine

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When the “S” Word Is Unspoken

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Note: this is a highly disguised story for reasons that will be immediately obvious. I got an invitation a few months ago to give a...
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Reform is needed for unaccredited registrars

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Honouring the body we touch

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Touch has been used in healing since ancient times. Touch can be a way of connecting with our patients, a way of expressing compassion....