Sunday, June 17, 2012

Goodbye, Dr. Welby

Another doctor sent out his retirement letter today. I read it, thinking that we are seeing the end of an era. The days of your family doctor actually being your doctor "til death do you part" is over, gone the way of house calls and the traditional black bag he carried. We have replaced them with computers and sub-specialists. This is the day of a team of specialists, none of whom really know who you are, and rarely communicate with each other....or you!
Don't get me wrong, Medicine is better than ever! Knowledge has increased dramatically, new drugs and procedures save lives, everything that science has brought us has improved both longevity and quality of life.  This is the science part of the "Art and Science" that is Medicine.  Art, however, has diminished in popularity and importance.
 There seems to be an inverse correlation between the two, which is tragic as far as I'm concerned. The smarter we get, the less we care about the people we see every day.
We care about symptoms, test results, standards of care, even wait times.....but don't know the person it all revolves around.
The old way of black bag medicine and house calls told us so much more about our patients. We could assess mental status, depression, financial well being, diet, and safety concerns in just minutes in a house call. That throw rug could be removed before the fall that fractures a hip. Is there enough firewood or heating oil for the winter? Who else lives here?
I don't think "health care reform" will do much good. We need more time with patients, more hands on, low tech medical care....not the fancy machines and tests and computers that substitute for real caring.
Medicine IS an art and a science; unfortunately Art is being overshadowed by Science and a growing corporate mentality. Money has replaced ministry. Computers take the place of compassion; and the entire process is rushed and depersonalised.
Hippocrates is rolling over in his grave!