“I don’t need no doctor, ‘cause I know what’s ailing me.
He gave me a medicated lotion
But it didn’t soothe my emotion”
-John Mayer
If someone asked you to draw your image of medicine, what would you sketch? Would it be a person wearing a long white coat with a stethescope? Would your picture be set in a hospital room, the ER or the office setting? Would there be any patients in your image? What about computers and telephones and pagers? Maybe your picture would take place in the OR with surgical instruments all lined up?
Would your image change at all if someone asked you to draw what medicine will look like in 20 years? In 50 years? 100 years?
Who cares what medicine looks like, you might be thinking to yourself. Why does it matter what my personal image of medicine looks like?
I am here to tell you that it matters a great deal. Most of us can agree that our medical system is not perfect and that there is lots of room for improvement. I will not use this space to rehash the long list of issues that plague our health care system and field of medicine–there are lots of places to find a laundry list of these issues.
The interesting aspect, to me, though, is that most of us undervalue our roles in this process. We sense and can feel that we want more out of medicine, yet at the same time, we feel complacent about where we are. We often act like a deer caught in headlights, frozen in the stillness of not knowing what to do.
And that is where your wonderful drawing comes back to mind. I think we as doctors do a much better job acting according to our individual passions and interests than when we all have to make decisions by committee. We are fiercely independent people who like making decisions–we do this all the time, every day. This is what allows us to be great doctors–we can make very quick decisions under pressure over and over again.
But put us together as a group and ask us to make decisions, not so good. This is why, I believe, the images of medicine we draw mostly look the same. For some reason, we have accepted our roles as physicians in the spirit of wanting to help others but confined by a system of medicine that restricts our innovative capacity.
The look and feel of medicine has not changed much at all in several decades. And likely won’t change much in the decades that follow. This is quite surprising knowing that we are so good at making decisions and acting upon them. So what is going on here?
My hunch is that we have been trained in a medical system that belabored the point of “this is how medicine is practiced.” Medical education and training very much focus on the technology and innovation of our tools–the medicines we prescribed and the surgeries we perform–but do not focus on the innovation about how we, as doctors, actually practice medicine. This makes sense as we have been led to believe the mantra: “if it ain’t broke, don’t fix it,” that has been passed down from generation to generation.
Back to those drawings again: I believe that any changes and improvements we want in medicine will not come from committees and consensus statements and guidelines and protocols, but rather will be sparked by individual doctors innovating their individual practices. We have shown throughout history that when we get in groups, our innovative capabilities diminish compared to our innovative capacity we show as individual decision makers.
I think we are fooling ourselves to think any bit differently. All of us literally have the ability to innovate and improve upon the way we practice medicine. This is how the innovations and changes we seek will be sparked–one doctor acting upon her vision for a better way. We should feel empowered in our roles of decision makers and not relinquish our position to pharmaceutical companies, the insurance industry or the government bureaucracies.
For far too long we have been thinking that our precious medicine is better off being moved by others. Instead we should be making those movements with our patients in our very own practices.
Patients are longing for more efficient ways to connect with us and interact with us. But frankly, most of us are too busy keeping up with everyone else’s (pharmaceutical companies, insurance agencies and government mandates) to even notice. It is time we individually modernize our medicine to fit the image we want to see.
So instead of waiting for some group or organization to decide what direction we should be headed, do what you have always done best: make up your mind and go there now.
Craig Koniver practices integrative medicine and consults with physicians at The New Rules of Medicine.
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