The myth of physician omniscience

How is a doctor allowed to mess around with body parts he doesn’t understand?

If doctors were required to understand everything we touched we wouldn’t be able to touch you at all!

The human body is still a deep mystery. Doctors understand more than most people, but what we know is still a vague approximation. Just because our educated guesses often work out well doesn’t mean we have any idea what’s actually going on.

It is a popular myth that doctors know exactly what your body is doing. The myth assumes the human body is a machine that is even understandable in the first place. Doctors learn a ton of stuff in medical school so they must understand everything the body does or can do, right? TV medical dramas have reenforced this myth without you even realizing it. If you fart or have a rash a doctor should be able to explain exactly why your body is doing that.

I hate to kill your Santa Claus, but MD’s don’t understand with any real depth what is going on in your body most of the time.

We are still be useful, but we don’t always know what’s going on behind the scenes anymore than you need to understand the internal combustion in order to press the gas pedal. Human bodies are exponentially more complex and varied than engines so when what we do doesn’t work, we can be at a loss to know why, although we can often make up some bullshit that sounds convincing.

Mythbusting

Doctor D has tried to disabuse people of this impossible myth, but nobody’s listening.

Patients either don’t believe me, “How nice of you to be so humble, doc, but I know you know what’s going on,” or they assume the lack of knowledge is some default in my training, “Okay Dr. D if you’re incompetent then refer me to someone who does understand!”

People just refuse to believe that there could be things that no doctor understands. The body is just too complex! Every human body is different and is constantly interacting with your mind, soul, other humans, and the environment. Not only is there a lot we don’t know. There is a lot that will always be impossible to know.

So, why is the myth of physician omniscience so deeply ingrained? When a wrong idea won’t budge it’s usually because it satisfies a deep psychological need.

No thanks, we prefer myth to reality

Being ill is terrifying. When your body begins to betray you it is natural to want to know why. Patients need to believe that somewhere out there is a doctor who understands this. In their imagination patients replace doctors’ vague, tentative understanding with a mythic understanding that is complete and without doubt. “It’s okay that I feel out of control, because my doctor is on top of it!” This is why mystery illnesses are so unsettling. It feels like like being in speeding car with no one at the wheel.

Doctors are also responsible for this myth. We perpetrate this falsehood for 2 reasons:

  • First, we want you to trust us. It takes a lot of trust for you to ingest the chemicals we give you or let us cut you open. We fear that if you knew how little we understand the bodies we work on you wouldn’t let us near you.
  • Secondly, we lie to ourselves. Medicine works. This is a good thing, but it allows us to mislead ourselves about how deeply we actually understand what’s going on. It also takes a lot of self-confidence to take on the care an ill person. Imagining we have god-like knowledge of the body helps us banish self-doubt. Unfortunately, banishing self-doubt is a double-edged sword: It can give us the confidence we need to pull of some incredible healing, and it can blind us to the humility and insight needed to acknowledge when we don’t understand.

One thing you can take as gospel: If any physician tells you they totally understand your body they are either lying or deluded.

How to live without the myth

This is good and bad news for you. The good news is that having and MD doesn’t make your doctor the final authority on you. Understanding this can allow you and your doc to have frank discussions on what we do and don’t know about your body. The bad news, of course, is that full understanding of your body is impossible.

But realizing that the body is a fearful and wonderful thing isn’t such a bad discovery. Appreciate your body for the mystery it is.

“Doctor D” is a physician who blogs at Ask An MD.

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  • http://www.facebook.com/people/Jackie-Swenson/100000046998781 Jackie Swenson

    Communication is the key – the problem is that physicians and ‘us’ don’t speak the same language.  I was fortunate to have studied ‘medical terminology’ and had had training in medical librarianship.  After the first of my 5 ‘major’ surgeries, I took Anatomy & Physiology in our local college in the mid 90′s.  Little did I know that my curiosity and my desire to know more about ‘myself’ would save my life again and again…

    Doctors don’t like us to be ‘knowleable’ – they don’t have enough time to listen to us arguing for our case.  That’s why we need other resources: 2nd opinions, legal counsel, patient advocate, Internet… etc. 

    The saying: “Just because you are paranoid doesn’t mean there’s nobody out to get you.” ought to be rewritten for our physicians as: “Just because your patient is paranoid doesn’t mean he/she is not suffering from ‘real’ illness. 

    • http://www.facebook.com/flesheatingemu Bion Alex Howard

      Agreed — I think doctors are teachers, first and foremost. Understanding a disease is useless if the patient won’t stick to recommended treatments because they don’t understand why they need it or how it works.

      I disagree about the desire for knowledgeable patients, though; a patient who takes interest in their disease can be one of the strongest allies of a doctor. The real problem is patients stop listening to their doctors because they think they know better. This isn’t purely a health care issue, though — it’s a human issue. Hubris will always, always, lead to worse outcomes. 

  • http://www.bryantsstatisticalconsulting.com Donald Tex Bryant

    Dr. D, wonderful insights and comments.  Looking at your ideas from another perspective:  if we fully understood the human body and its functioning, there would be no need for medical research.  Another way to restate your point of view, “Now we see through mirror dimly.”

     

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