Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Questioning medical traditions for the sake of patient care

Brian Elliott, MD
Physician
January 20, 2023
Share
Tweet
Share

The United States consumes forty-six million turkeys every Thanksgiving. Have you ever wondered why? When traditions take hold in society, we start to forget why they existed in the first place. For example, the tradition of eating turkey on Thanksgiving started with a writer named Sarah Josepha Hale, who published scenic depictions of American life in New England. She subsequently campaigned for everyone to adopt her depiction of a cooked turkey and togetherness while tensions in the United States mounted during the Civil War era. Hale’s campaign contributed to Abraham Lincoln declaring Thanksgiving a holiday, and turkey became a staple at dining tables across the country. Asking why we eat turkey on Thanksgiving shifts the tradition from being dogmatic to having purpose, which is to promote togetherness among the American people.

Medicine is not immune to this phenomenon of forgetting the origins of ubiquitous traditions. Providers don a white coat that is covered in potentially pathogenic bacteria, which was initially used as a technique in antisepsis. We swear to multiple different Hippocratic oaths, none of which can be definitively attributed to Hippocrates. The irony behind some medical traditions is hidden in plain sight. Their ubiquity invites complacency. We may not think about the pros and cons of these traditions just as we may not think about why we eat turkey on Thanksgiving. This indifference is fine for poultry, but not when it comes to medical care.

The malice in medical traditions going unnoticed is not only ironic perpetuation but also that they slipped through the scientific revolution unscathed. Our field, which prides itself on scientific methodology and empiric evidence, shouldn’t hinge such commonplace practices on “that’s the way we’ve always done it.” Our physical exams should be intentional diagnostic reasoning, not an outdated routine practice. Our medical education should focus on yielding the best 21st-century physicians, not perpetuating 19th-century courses.

The point is not that traditions are inherently bad. I love Thanksgiving turkey, but turkey can’t hurt patients. The bacteria on the sleeves of a white coat, the appearance of a misunderstood Hippocratic oath in courtrooms, and overdiagnosis from a suboptimal physical examination can all hurt patients. They don’t need to be thrown away, but they must be understood. They need to be studied.

We need to deliberately evaluate traditions because they matter. White coats affect patient perceptions of trustworthiness and professionalism. Nearly 90 percent of physicians report that oaths have at least some influence on their medical practice. Therefore, it is important that we get medical traditions right. If physicians prescribed medication as often as they use medical traditions, while knowing as little about the medication as they do about medical traditions, it would be malpractice.

A heavy bias toward the status quo has protected medical traditions for too long. It is time to ask why. Ask if you’re doing something because it is the best way, or because that’s how you’ve always done it. Ask whether your white coat is worth the risk of infection, what ethical principles you should swear to, and what the accuracy is of that stethoscope you carry. Above all, ask how these daily rituals are affecting patients.

Brian Elliott is an internal medicine chief resident.

Prev

Balancing patient care and bureaucracy [PODCAST]

January 19, 2023 Kevin 0
…
Next

The unspoken contract between doctors and patients: Navigating mental illness in the jail setting

January 20, 2023 Kevin 0
…

Tagged as: Hospital-Based Medicine, Primary Care

Post navigation

< Previous Post
Balancing patient care and bureaucracy [PODCAST]
Next Post >
The unspoken contract between doctors and patients: Navigating mental illness in the jail setting

More by Brian Elliott, MD

  • The controversial origin of the Hippocratic oath

    Brian Elliott, MD
  • What John Snow and cholera tell us about the COVID pandemic

    Brian Elliott, MD

Related Posts

  • A universal patient medical record

    Michael R. McGuire
  • The impact of panels early in medical school on informing patient-centered care

    Sangrag Ganguli and Varun Mehta
  • More physician responsibility for patient care

    Michael R. McGuire
  • A new boon for Big Data and patient care

    Michael R. McGuire
  • The patchwork quilt of my medical care

    Michele Luckenbaugh
  • The ultimate in patient empowerment: advance care planning

    Patricia McTiernan

More in Physician

  • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

    Arthur Lazarus, MD, MBA
  • Breaking free from restrictive covenants to combat burnout

    Raya E. Kheirbek, MD
  • From medical student to intern: Discovering a deeper connection with patients

    Johnathan Yao, MD, MPH
  • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

    Jennifer Lycette, MD
  • Decoding name displays in health care: Privacy, identification, and compliance unveiled

    Deepak Gupta, MD
  • Master time management with 7 productivity strategies for optimal results

    Farzana Hoque, MD
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

      Harvey Max Chochinov, MD, PhD | Conditions
    • Master the ABIM Certification exam with effective strategies: insider tips for success

      Farzana Hoque, MD | Education
    • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

      Arthur Lazarus, MD, MBA | Physician
    • Breaking free from restrictive covenants to combat burnout

      Raya E. Kheirbek, MD | Physician
    • Fixing the system and prioritizing patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From medical student to intern: Discovering a deeper connection with patients

      Johnathan Yao, MD, MPH | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Sickle Cell Disease Poses Major Risk for Pregnant Black Patients
  • CAR-T Tops Standard Care in Heavily Pretreated Lenalidomide-Refractory Myeloma
  • Artificial Intelligence Could Improve Medical Practice -- But Only if Done Right
  • Huntington's Disease Chorea Improved With Valbenazine
  • T-DXd Proves Mettle in Multiple Solid Tumors

Meeting Coverage

  • CAR-T Tops Standard Care in Heavily Pretreated Lenalidomide-Refractory Myeloma
  • T-DXd Proves Mettle in Multiple Solid Tumors
  • Preoperative Ocular Surface Disease Algorithm Re-Introduced
  • Omitting RT Safe in Many Locally Advanced Rectal Cancers
  • Novel IDH1/2 Inhibitor Shows 'Dramatic Effect' in Low-Grade Glioma
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

      Harvey Max Chochinov, MD, PhD | Conditions
    • Master the ABIM Certification exam with effective strategies: insider tips for success

      Farzana Hoque, MD | Education
    • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

      Arthur Lazarus, MD, MBA | Physician
    • Breaking free from restrictive covenants to combat burnout

      Raya E. Kheirbek, MD | Physician
    • Fixing the system and prioritizing patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From medical student to intern: Discovering a deeper connection with patients

      Johnathan Yao, MD, MPH | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Questioning medical traditions for the sake of patient care
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...