The best doctors teach their patients

The Oxford English Dictionary (OED) identifies the first use of the term “doctour”, as the year 1303 AD, shortened to “doctor” in the 1557 addition of the Geneva Bible.  The OED first defines doctor not as a caregiver or healer, not as a science researcher or expert and not even as one with an advanced educational degree.  The OED, the world’s foremost English language dictionary, defines “doctor,” 700 years ago and today, as “teacher.”   It is a powerful legacy and a responsibility that physicians never forget.

From the time they enter medical school to begin an apprenticeship that will take them through a career of constant learning, physicians join an unbroken chain of professional and volunteer educators dating back to Hippocrates.  Whether they are in the anatomy lab, the operating room, on the wards or in the clinics, practitioners senior to them, perhaps by only a year or maybe an entire career, are involved in one-to-one teaching.  The entire profession is built on the premise; videre unum, noli unum, docent; see one, do one, teach one.

Every physician participates continuously in this process. The fourth year medical student teaches the third, the senior resident the intern, the attending the fellow and the most senior practicing doctor often takes time to teach the most junior nurse.   Moreover, in an anti-hierarchical way, knowledge flows both up and down this path as the energy and innocence of youth combine with the wisdom of the old, to open new areas of learning and discovery.

Physicians teach everywhere and by every means.  From small seminars to great lectures, from mentoring one to guiding many, from articles to books, in the hospital, clinic or office and most recently from single emails to blast blogs and websites that span the Internet.  Physicians are trained and nurtured by this process and in turn train and nurture those that follow.

The best doctors remember that their calling is not only to teach practitioners of the health sciences; it is their duty to teach their patients.   Every patient can identify physicians whom have the patience and skill to explain the complex in clear language, allowing the patient to make better decisions and have better control of life.  Knowledge is to fear, as water is to fire or as oil spread on a turbulent sea, brings calm.  Patients are the greatest benefactors of a deep educational culture connecting the centuries and ending at individual bedsides.

In can not be a coincidence that the first known use of “doctour,” seven centuries ago, occurs just 13 years after the first printing of another word which helped define the profession.  In 1290 AD, on page 308 of The South English Legendary, is found “techere,” the ancestral root of what would become “teacher” many years later.   In a slightly different world, or in a vaguely remembered past, there might have been a time when the office door would open, the nurse step out and she would say, “Mrs. Smith, the teacher will see you now.”

James C. Salwitz is an oncologist who blogs at Sunrise Rounds.

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