Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Is the medical profession at its end?

James C. Salwitz, MD
Physician
July 8, 2017
Share
Tweet
Share

At the graveside, they still talk about judgment, intelligence, and the wisdom that is the practice of medicine.

Deans and health care leaders wax poetic as they tell stories of great cures to lift in memoriam remarkable healers. Yet, though we bow to Hippocrates, Osler, and Salk, the time has come to mark a revolution in human history: The art of medicine is dead.

It is not that doctors have fallen from the one true path. It is not that they have lost focus or forgotten important theory. It is not that physicians heal without altruism, passion, or perfection. It is more basic. Art is to medicine as blacksmiths are to airplanes, flat earth is to astronomy, or prayer to the atheist. It is an idea relegated to the past. The doctor, as artist, lies in the grave.

This “art” of medicine is not communication, empathy, or drive. Rather, the art of medicine is how, for millennia, doctors have made decisions in complex situations when there was risk to the patient, with a significant element of the unknown: a life or death “educated guess.” The unknown may be insufficient knowledge about the disease, an incomplete understanding of a patient’s health, lack of foresight of potential complications or an absence of definitive knowledge of the correct, best treatment. It has often been all of the above. The “art of medicine” has been about judgment, experience, and action, when the “right way” was not clear.

We have long depended on the artists of medicine to make decisions which affect human lives, without really knowing what is happening or what that intervention would do. We have been without an understanding of biochemistry, physiology or pathology, had few active therapies, and had little ability to predict an individual’s future. There were no tests beyond those caught with the eye and the touch of a hand, and very little “objective” data. There was art because there was no optimal path, no “indicated” treatment. Just the need to make a decision. To act. To care.

Which is now dead. We can no longer say we do not understand pathophysiology and do not have revolutionary ways with which to measure it. We are not without a broad range of treatment answers for most medical conditions. Research tells us what the probable benefits and side effects will be. We are no longer in caves painting pictures on the wall, or serve in massive putrid wards without a basic concept of what is happening in front of us. For almost all health decisions, there is now a right and a wrong, an optimal, a most probable action. The practice of medicine will never again be based on a clinician’s experience, observation or gut. It will be based on hard-fought scientific reality.

Shoveling dirt on the casket is that most solemn of pallbearers … the clinical pathway or guideline. No feeling. No passion. No caring. Just metrics, research and statistics. Physicians once trained to make decisions on their own, to be responsible not only for patient care, but for interpreting primitive science, conflicting superstition and their instinctual observations of medical events, now feel cast aside. Indeed, if all has been decided, if all paths are clear, one might ask: Is the medical profession at its end?

This is an absurd question which fails to understand the nature of what is means to be a modern doctor. It is like asking if we need carpenters, because we have power saws, cooks, because we have microwaves or orators, because we have microphones. Yes, having clear pathways and data massively changes medicine. Nonetheless, in not the slightest degree does it decrease the vitality or need for the medical profession. Quite the opposite, it makes us much better at our job.

We are called to heal. With clear answers and understanding, we can connect and empower each patient, giving them a place to turn when they are sick and frightened. We can collect and process extremely complex information which makes possible medical analysis and we can make diagnoses more accurate than ever. This becomes better treatment and, in our most critical skill, we can teach, direct and apply healing. Revolutionary cures give doctors the ability to confidently enable each patient to journey toward health. Knowing that there is an optimal way, a more perfect result, does not in some bizarre way make doctors obsolete. Rather we are reaching toward the pinnacle of our profession.

The doctor of today and tomorrow is the ultimate compassionate healer. We convey our patients through and beyond illness. We guide our patients back to lives of meaning. We have so much opportunity, such a burden of possibility to be personal practitioners, to guide each patient so they may return to life. It is a rebirth of medicine, moving beyond primitive confusion, suffering, and loss, to empowerment, strength and real hope. The art of medicine is dead. Long live the art of medicine.

James C. Salwitz is an oncologist who blogs at Sunrise Rounds.

Image credit: Shutterstock.com

Prev

We are not shielding our patients from harm

July 8, 2017 Kevin 4
…
Next

We're smart doctors. But why aren't we so smart about our health?

July 9, 2017 Kevin 0
…

ADVERTISEMENT

Tagged as: Primary Care

Post navigation

< Previous Post
We are not shielding our patients from harm
Next Post >
We're smart doctors. But why aren't we so smart about our health?

ADVERTISEMENT

More by James C. Salwitz, MD

  • Each line on the radiology list is a patient’s line in the sand

    James C. Salwitz, MD
  • The broader mission for hospice care

    James C. Salwitz, MD
  • This doctor gives his cell number out to patients. He explains why.

    James C. Salwitz, MD

Related Posts

  • The medical profession needs more shadowing opportunities

    Edwin Leap, MD
  • Digital advances in the medical aid in dying movement

    Jennifer Lynn
  • Sleep and the medical profession have an uneasy relationship

    Yoo Jung Kim, MD
  • Restoring the trust in the medical profession

    Philip A. Masters, MD
  • Breaking the silence within the medical profession

    M. Asad Khalid, MD
  • Does the medical profession need their version of the NRA?

    Thomas D. Guastavino, MD

More in Physician

  • The shocking risk every smart student faces when applying to medical school

    Curtis G. Graham, MD
  • The physician who turned burnout into a mission for change

    Jessie Mahoney, MD
  • Time theft: the unseen harm of abusive oversight

    Kayvan Haddadan, MD
  • Why more doctors are leaving clinical practice and how it helps health care

    Arlen Meyers, MD, MBA
  • Harassment and overreach are driving physicians to quit

    Olumuyiwa Bamgbade, MD
  • Why starting with why can transform your medical practice

    Neil Baum, MD
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Is the medical profession at its end?
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...