Robert E. Kravetz, MD, FACP, MACG, Clinical Professor of Bioethics Medical Humanism at the University of Arizona, College of Medicine - Phoenix
Digital - March 2022
“One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.” - Francis W. Peabody, MD
There was a time when there was a harmonious blending of technology and humanistic medicine; when patients were treated as a person and not as an object with a disease process. It enabled me to always see my patients as unique individuals with a disease to which each one of them responded in a very specific physical and emotional way. The disappearing art of medicine needed to be much more widely disseminated to the current generation of practicing physicians and the young physicians in training.
In recent years, this has all but disappeared. Families and patients are keenly aware of this. We hear comments such as: “the doctor is always in a hurry, he did not listen, or he did not really seem interested in me or my loved one. I was never asked how I felt, all I was told that there would be more tests,” etc. So often tests are ordered without any explanation of their relevance or benefit and no mention is made about the actual procedure or any discomfort or inconvenience that the individual might experience. Doctors routinely order a newer test and still perform the older less accurate one resulting in duplication of information and additional cost.
I have witnessed the slow dissolution of the physician-patient bond and have seen it virtually disappear in recent years. With every new advance in technology, particularly with the advent of managed (or should I say mismanaged) care, another nail is driven into the coffin of caring. Physician selection is no longer a matter of free choice, but rather it is dictated by health plans, insurance companies, and employers. It is not uncommon for a patient to be shifted from physician to physician each year resulting in a lack of continuity of care and no chance at all for developing that bond.
This is not to imply that the advances in technology have not enabled us to diagnose more effectively, treat, and cure more often adding years to patients’ lives, but in many cases quantity of years does not equate to a better quality of life. I support and cheer the new advances and the benefits of technology; however, this has come with a price, namely the disappearance of the humanistic aspect of medicine.
Practicing physicians today will rightly say that pressure and a lack of time that they can spend with patients prevents them from forming a close physician-patient relationship. I certainly understand and empathize with this. The questions is “how can the art be resurrected”? I would be happy to hear any suggestions in this regard or other comments regarding this issue.
- Quote from Peabody, Francis W: Doctor and Patient, New York: The Macmillan Company, 1930.