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January 11 , 2009

Proper Doctoring


There are many textbooks which give detailed descriptions of the causes, clinical features and treatment of disease. There are a number of books devoted to clinical methodo­ logy which tell the student the questions which he must ask and describe the physical signs that he should seek. The authors of these books rarely devote more than a page or two to a job description and advice on how to acquire clinical skills. Although a sound knowledge of the facts is essential, a good doctor differs from a bad doctor more by his attitude and craftsmanship than by his knowledge. These important matters receive scant attention in the textbooks because the authors regard them as part of the spoken tradition which is taught at the bedside or in the clinics and is absorbed by watching clinicians while they are dealing with patients. The image of the doctor who greets patients with his pen poised over a prescription pad, and the calls for holistic medicine, imply that a number of students do not pick up the relevant attitudes and skills on the way. That this feeling is shared by the profession itself is suggested by the forma­ tion of a society to promote the treatment of the whole patient, and another for the promotion of humanism in cardiology. Good doctors have been treating the whole patient humanely since the profession was founded, and I find it shocking that it is thought that such societies are necessary.
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