The art of practicing medicine is dying, soon to be replaced by the art of template medicine.
Modern medicine is based on laudable terms: “quality,” “outcomes,” “cost effective,” and “evidence based medicine,” which all sound good when sold in infomercials to the medical world and public. When examined closely, all are vague and open to abuse.
Each of these terms is intent on taking the human factor out of medicine. Each is a dagger dug into the heart and soul of the “art of practicing medicine” approach. It is my belief that, in standardizing medical care, caring for the individual is sacrificed for the sake of caring for quality indicators, protocol compliance, and cost.
The physician-patient relationship is being replaced by the physician-EMR-government-insurer-employer relationship. What a pity. Art is in the eyes of the beholders. Yes, the art of medicine is far from perfect, even marred by human frailty, but still a beautiful thing from my point of view.
I miss the good old days. My computer is like a black hole, constantly pulling me away from what I most want to do: care for my patients. The insurers and government are like a black hole, sucking in huge amounts of my energy, keeping me from patient care. On a daily basis, I fight to maintain my art.
One day, I’m going to retire. I’m going to quit being a primary care physician, drop off the grid, and settle in to being a family doc again. I’m going to thumb my nose at the EMR, the government, and the insurers. I’m going to set my own quality standards and let my patients be the judges of the pictures I paint. I’m going to return to my roots as an artist, practicing medicine as physicians have done for hundreds of years. I’m going to give individualized care to those who are in need, unencumbered by the modern world of computers, protocols, and guidelines.
I look forward to retiring to the true practice of medicine. Until then, I will work hard not to fall into the great black hole of today’s medical world.
As protocols and EMR drive behavior, modern medicine loses its heart and soul. The art of practicing medicine is dying at the hands of evidence based medicine, guidelines, and the background drone of key strokes and mouse clicks. I fear that quality care and outcomes will be measured by the art of practicing template medicine.
Stewart Segal is a family physician who blogs at Livewellthy.org.
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