In his essay Teacher and student, Sir William Osler noted that: “The practice of medicine is an art, based on science.” But given the ascendance of science and technology in modern medicine, is the art of medicine still relevant in the new millennium?
In his book, Science and the quiet art, Sir David Weatherall, Regius Professor of Medicine, argues that the art of medicine “describes the holistic approach to the care of patients. While it includes skills in diagnosis and treatment, it also encompasses the management of every aspect of patients’ reactions to their illness and its impact on their lives.” The relevance of the art of medicine for today’s practitioners recently surfaced in the report on modern medical professionalism by the Royal College of Physicians of London. In defining contemporary medical professionalism, the report’s working party discarded the concepts of mastery, autonomy, privilege, and self-regulation. “Mastery”, because it “can suggest control, authority, power, and superiority.” “Autonomy”, because it “might suggest that a doctor has the authority to act independently of both the wishes of the patient and the preponderance of medical evidence.”
Surprisingly, the “art of medicine” was also rejected — in favour of “judgement”. And the reason? “Doctors are increasingly going to act as interpreters and prescribers of information. They need to be well positioned to assist patients in understanding their illness and the risks they face” and to share patients’ concerns with “finding a path through the ‘indeterminacies’ that disease can bring”. To encapsulate this, “judgement” was deemed to be a better descriptor.
The art of medicine has a long history reaching back to Hippocrates. Sadly, the proposed “judgement” is reductionist and fails to capture the essence of the art of medicine.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.