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