Medical education is not just a program for building knowledge and skills in its recipients... it is also an experience which creates attitudes and expectations. A. Flexner
It is much more important to know what sort of patient has a disease than what sort of disease a patient has. William Osler MD (1849 - 1919)
I really like this (counterintuitive) thread. My favorite Steve Martin skit involved Steve as a medieval barber who (dressed in starched white lab coat) was telling a patient with abdominal pain, "We used to think this was caused by witches and evil spirits, but now we know (looking particularly smug) it's caused by a large toad in the stomach." (from Paul Nutting)
Mark Twain ridiculed the stereotypical features of physicians, including illegible handwriting "which from the beginning of time has been so disastrous to the apothecary and so profitable to the undertaker" Twain had no difficulty describing the shortcomings of each of the various medical approaches available in this unregulated era. Allopathic medicine was notable for its heroic and toxic treatments. Homeopathic medicine, using infinitely small and diluted doses of agents that mimicked the disease being treated was the essence of non-therapy. If another citizen preferred to toy with death, and buy health in small parcels, to bribe death with a sugar pill to stay away, or go to the grave with all the original sweeteners undrenched out of him, then the individual adopted the "like cures like" system, and called in a homeopath physician as being a pleasant friend of death's. Alternative approaches, such as hydropathic medicine, appeared equally ineffective. Twain was intrigued by those who combined features of all of the available treatment programs: "...there were those who saw "good in everything" and who believed that whatever is is right, and these last mixed the allopathic, homeopathic, and hydropathic systems, qualified each with each, and thus passed to their long homes, drenched, pickled, sweetened, and soaked." see more at Mark Twain, Honorary Doctor
Thanks to David Loxterkamp, M.D. (NEJM, Dec 26, 1996 - "Hearing Voices...") for a guiding New Year Thought... " Yea, though we walk through the valley of managed care and our business (if not our soul) is traded on the floor of the New York Stock Exchange, we are lucky to be here, doing what we do, still students of medicine, tending to the afflictions and infirmities of those who call us doctor."
CMDA Executive Director David Stevens, M.D., comments: "If society couldn't control Jack Kevorkian when he took the lives of 75+ people that were not terminally ill, what makes us think we can control hundreds of thousands of U.S. doctors under legal physician-assisted suicide?
If I’d have know they were going to schedule this patient today, I’d have called in sick. by one of our least complaining faculty in Nebraska.
Carl Hammerschlag was asked by a Native American patient if he could dance. He shuffled his feet a bit and the patient said, "That’s good." Realizing that there was some purpose to the patient’s request, Carl asked him if he would dance as well. The patient adjusted his oxygen cannula and danced vigorously right there on his bed. Carl paused for a moment, then asked the patient if he could teach him to dance like that. The healer said, "I can teach you my steps, but you must hear your own music."
Unfortunately, there is a pervasive sense in the work world that we are more responsible to our tasks than to our people, that our jobs take precedence over our relationships, and that our achievements rather than our character measure our worth. Andy Macfarlan, FP in North Carolina
My favorite quote for American health care (RCB):
Americans can always be counted on to do the right thing,
....after they have exhausted all other possibilities. Winston Churchill
The basic science of medical education is money
Heat is to water as money is to curricular change -
John Hickner, M.D.
I figure that the only thing a test tells you is what you know on one particular day about what someone else thinks is important. Ed Mantler, FP resident on day of inservice exam 1995
Physicians occupy an unusual spot in the social structure of rural communities. From an economic standpoint, they are successful entrepreneurs, well-paid business people similar to bankers and lawyers. On the other hand, they are also social servants like policemen or teachers, just as essential to the welfare and functioning of the community but paid for through a fee-for-service mechanism outside of local community control. This anomalous status requires some fairly innovative interpersonal and structural relationships to strike a workable balance. Rosenblatt and Moscovice, 1982
Did you know that Nebraska has the only Frontier County in the nation? Look it up! Shouldn't this help us in getting grants?
The Real Frontier lies in the stimulation of the Creative mind of Man. - Mari Sandoz
"I tell you the old-fashioned doctor who used to cure you of all illnesses has quite disappeared. Now there are only specialists and they all advertise in the papers." F. Dostoyevsky The Brothers Karamazov 1880 via Joseph Merrill M.D.
Built within our traditional medical systems are roadblocks. I find many of these to be irrelevant or myths. I try to spend my time getting by these to deliver the best care that I can. Bob Boyer, Rural Doc in Kingman, KS
Compare and contrast the following two statements. Your solutions must be legible, understandable by all ages of voters, and not cost more than 10% of the GDP. More importantly, voters must think that they are getting the best health care that they can get.
The wise family physician is one who knows how much he/she is but is more concerned with how much more he/she can become. Hunter Woodall, Family Physician