Physicians’ values versus patients’ needs

Public expectations and physicians’ responsibilities. Voices of medical humanities.

John K Crellin. Abingdon: Radcliffe Publishing, 2005 (vi + 165 pp). ISBN 1 85775 642 8.

John Crellin, Professor of the History of Medicine at the Memorial University of Newfoundland, explains that “underpinning this book is the perception that the values held by physicians have changed in recent years and may not be in keeping with the needs of patients today”. He and his colleagues (including students) have dipped into popular culture, literature and film to illustrate their point.

The material is organised according to seven key professional roles: the doctor as expert and clinical decision-maker, communicator, collaborator, manager, health advocate, scholar and professional. These are the roles identified by the CanMEDS 2000 Project1 and widely adopted in Canada and other countries, including Australia, to guide curriculum development in postgraduate training programs.

These roles provide one “axis”, with various forms of literature, the arts and popular culture providing the other. It’s a patchwork of different pieces and genres with little overall coherence, but this is not necessarily a bad thing; the book is more like a “dress-up box” than an exegesis. Excerpts vary from the memorable to the mundane, with an understandable bias towards Canadian literature.

A rather more impressive literary collection appears in a new book, The moral of the story: an anthology of ethics through literature.2 This one is a knockout — a necessary quality for a book that is priced at $230.00. Here we have some of the best chapters from the best books by the best writers, arranged and annotated in “ethical clusters”.

“Bedside teaching” usually occurs around the patient’s bed, but another equally important form of bedside teaching occurs when we spend a little time with books like these at the end of a hard day. Just beware: if your bedside table looks like mine, it is almost certainly an occupational health and safety hazard.

Jill GordonDirector, Centre for Medical Humanities University of Sydney, NSW