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The Practice of Medicine: Art or Science?

Discussion in 'Pre-Medical - MD' started by pillion, Apr 28, 2004.

  1. pillion

    pillion Senior Member
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    A discussion in the Everyone forum about the purpose of humanities pre-requisites for medical school led to the question: is the practice of medicine an art or a science? Or, in what sense is it both? While pre-requisites and training focus on scientific competence, how does one learn the ART of medicine?
     
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  3. Heal&Teach

    Heal&Teach cogito ergo sum
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    I agree... but there is an underlying art to the profession that allows you to be a more successful business person. The art can be learned if one is open to knowing and understanding how to be a compassionate physician. I think that this is a primary reason for the "how to.." and "fundamentals" courses included within pre-clinical curricula.

    EDIT: where did the previous post go? My post may not make sense, but I responded to someone who said that medicine is a business first that makes the art and science of the profession more effective, but I argue the reverse.
     
  4. underAchiever

    underAchiever leoni ridenti
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    To quote Hippocrates" Life is short, the ART is long, opportunity fleeting, experience delusive, judgement difficult". The point, medicine was an ART before it became a science. The "Science" part can be crammed into somebody's mind, and even then it is an inexact science I hear. But the Art...let me make an analogy in painting, you could teach someone all about brushes and colors and canvass and there are virtuosos out there who can do anything with the brush but paint a great painting, a Renoir or Rembrandt, a work of art.
     
  5. pillion

    pillion Senior Member
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    ...but why do we call it an "art", as opposed to other technical skills are not considered arts?
     
  6. Gleevec

    Gleevec Peter, those are Cheerios
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    Yes, medicine was an art before it was a science. That is why bloodletting, phrenology, and the belief that highly toxic heavy metals cure most diseases were common for so long.

    Art and science are both creative, its just that art is creative throughout, and science is creative pre-experimentation. Because god knows you can support ANY hypothesis with creative experimental protocols or the interpretations thereof.

    Medicine does have some aspects of art in it, it has much more science, but medicine is independent of the two. Doctors should not try to be overly creative in treatments, unless as a last resort. Then again, doctors should not be cold scientific automatons either.

    If anything, ideal medicine is the perfect amalgamation of art, science, humanities, and communication.
     
  7. Neuronix

    Neuronix Total nerd
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    To me, science implies a formal process of testing hypotheses in the search of new information. To this end, medicine seems to be more of an art to me. It uses techniques and memorized facts to come to treat people. Yes, the art of medicine is an applied science, but that it uses scientific discoveries does not make it science. The art is tought through memorization of facts, practice, and experience. Is there any laboratory in medical practice anymore? Perhaps in pathology, but doctors don't run their own labs anymore. As new information comes down the scientific pipeline, that can be passed to doctors. This is why I think the MD/PhD is so important. Researchers (on the whole) don't understand what discoveries have clinical relevance (or even the clinical relevance of their own research many times), and doctors don't understand or don't have the training to perform their own research.

    Of course, there is a certain amount of testing and hypothesis in medicine. There is that in everything we do. But, do most doctors use controlled studies to determine what's better for their patients? Of course not, they can't. Unless they're a part of a formal research study (a minority of doctors and for one small aspect of care), they use accepted practices.

    Of course there are examples of medicine and research as art and science. However, on the whole I feel that medicine is much more of an art.
     
  8. pillion

    pillion Senior Member
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    I found this in Harrison's Internal Medicine; it's good.

    "The practice of medicine combines both science and art. The role of SCIENCE in medicine is clear. Science-based technology and deductive reasoning form the foundation for the solution to many clinical problems.... Yet skill in the most sophisticated application of laboratory technology and in the use of the latest therapeutic modality alone does not make a good physician. One must be able to identify the crucial elements in a complex history and physical examination and extract the key laboratory results from the crowded computer printouts of laboratory data in order to determine in a difficult case whether to treat or to watch. Deciding when a clinical clue is worth pursuing, or when it should be dismissed as a 'red herring', and estimating in any given patient whether a proposed treatment entails a greater risk than the disease are essential to the decision-making process that the skilled clinician must exercise many times each day. This combination of medical knowledge, intuition, and judgment defines the ART of medicine, which is as necessary to the practice of medicine as is a sound scientific base."

    It seems to me that the ART of medicine involves, not necessarily creativity, but intuition and good judgment. Of course, creativity is good, but the emphasis here seems to be on the character of the physician.
     
  9. underAchiever

    underAchiever leoni ridenti
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    Hence my Hyppocritic quote!
     
  10. pillion

    pillion Senior Member
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    ...which I liked. But, unfortunately, I don't think people take their oaths seriously enough.
     
  11. underAchiever

    underAchiever leoni ridenti
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    Like all seekers after a lost perfection, we yearn for something that never was; the moral purity of the ancient Oath-maker and Oath-takers is about as lost, and as irretrievable, as the continent of Atlantis. The consistent moral decency of any code is not a goal any less worth pursuing just because it is outside the reach of ordinary human behavior. The Greeks understood this, and they tried, as we try, to do what was expected of them. I would think that in their everyday practices, they were neither more or less successful at it than we are. And we don't even have their advantage of living on simpler virtures of a simpler times. I am including the code, for those who have not yet read it (if anyone), and to see how many times medicine is refered to as the ART.
    THE OATH OF HIPPOCRATES
    I swear by Apollo the physician, and Aesculapius, Hygeia and Panacea and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this covenant:
    To reckon him who taught me this ART equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring on the same footing as my own brothers, and to teach them this ART, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture and every other mode of instruction, I will impart a knowledge of the ART to my own sons, and those of my teachers, and to disciples who have signed the covenant and have taken an oath according to the law of medicine, but no one else.
    I will follow that system of regimen, which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.
    I will give no deadly medicine to anyone if asked, nor suggest any such counsel; and in like manner I will not give to a woman an abortive remedy. With purity and with holiness I will pass my life and practice my ART.
    I will not cut persons laboring under the stone, but will leave this to be done by such men as are practitioners of this work.
    Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves.
    Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken abroad, I will not divulge, as reckoning that all such should be kept secret.
    While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and pracitce of the ART, respected by all men, in all times. But should I trespass and violate this Oath, may the reverse be my lot.
     
  12. celticmists18

    celticmists18 california dreaming
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    that is a painting with a pretty broad brush.

    Anyone else feel like this thread is reincarnating answers they put on secondaries? or answers they gave in interviews?
     
  13. pillion

    pillion Senior Member
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    Celt, why the bitter tone, babe? I suppose you agree with the reject who responded to the initial question with, "it's just a business fool." Set some ideals for yourself, and don't assume everyone is as superficial as you make yourself sound.
     
  14. SunnyS81

    SunnyS81 Senior Member
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    I vote for art, but hopefully it will become a science in its entirety eventually.

    The idea of "evidence based medicine" is just now starting to make an impact (using studies to back up decisions and standard of care). Most of standard of care still seems to be a consensus.
     
  15. celticmists18

    celticmists18 california dreaming
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    First, NEVER NEVER NEVER call me "babe". Second, who are you to comment on my ideals when you don't know anything about me! I was responding to your little accusation about people taking there oaths lightly when I said you were painting with a broad brush . . .I take things like that VERY seriously. Third, you want my real answer to the question: none of us are qualified to answer it because none of us have actually PRACTICED medicine. Once we have actually practice it, and only then are we really qualified to make comments on its nature.
     
  16. pillion

    pillion Senior Member
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    Geesh... haven't you ever been to Louisiana? As for your ideals, I know nothing, just as you know really nothing about me, so lighten up. Anyone going into medicine should think about what they're getting themselves into. If you don't care enough to consider the nature of medical practice, post somewhere else. Otherwise, tell me what you think, "in what sense is medicine an art?"
     
  17. theduke

    theduke Brilliant rocket surgeon
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    I would be that reject. Believe whatever you want


    But if you open a clinic next to mine, I'll cut prices till you bleed, declare bankruptcy and accept my offer to buy you out.
     
  18. celticmists18

    celticmists18 california dreaming
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    its bebe (with an accent mark) . . . my family has roots in New Orleans.

    medicine is an art because it requires its practioners to interact with people during very stressful times. since it seems like all I do is tick people off I will refrain from further comment on this thread.

    for all my fellow cajuns/creoles: Laissez les bons temps rouler!
     
  19. pillion

    pillion Senior Member
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    ...what are the chances! I stand corrected.

    PS: Whose ticked off?
     
  20. pillion

    pillion Senior Member
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    ... as long as you bandage me up!
     
  21. celticmists18

    celticmists18 california dreaming
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    example of someone being ticked off. C'est tout ma cher.
     
  22. theduke

    theduke Brilliant rocket surgeon
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    Bleed as in bleed capital
    Sure in fact, I'll let you work for me. we can attack other clinics
     
  23. pillion

    pillion Senior Member
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    That's not ticked off; I get all big and green when I get ticked off.
     

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