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…
Read moreEvidence-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
This is Going to Hurt
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:...
Harnessing Grief Into Action: A Tribute to a Remarkable Woman
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...
Mentors, Sponsors and Gender Inequity
I recently attended a conference and heard a presentation delivered to female surgeons which addressed the subject of mentors, sponsors and gender inequity in...
From being bored to enriching life
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,...
Why half our patients don’t tell their doctors life-threatening details
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...
The Fragmentation of Medicine
I have witnessed many changes within medicine over the last 30 years – one of which has been the increasing fragmentation of medicine despite...
The Key to Orienting Incoming Residents and Fellows
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...
Are you trapped in time, or surrendered to space?
I used to live life ruled by time. I was not a very obedient subject, and was always running late, but it ruled me,...
Falling in and out of love with medicine
I loved studying medicine as a medical student. I was so curious to know how the body worked – how this bit interacted with...
How do we deal with the challenges of being a doctor...
Doctors spend a long time training to be doctors. It takes at least 10-15 years to complete our training, which means we are usually...
When the “S” Word Is Unspoken
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...
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...