"People pay the doctor for his trouble; for his kindness they still remain in his debt."
―Seneca (4 BC–65 AD)
Reflecting on my own 30-year career in health care, I have tried to focus on what changes during this time have made significant differences to patient care. Immediately, I note the rapid technological advances made in medical, surgical, and pharmacological therapies, which have spurred wonderful, previously unimaginable innovation that, in turn, has vastly improved clinical outcomes. These improvements have saved millions of people around the world from life-threatening conditions such as cancer and heart disease, and the importance of these advancements should not be understated.
Indeed, as a present-day example, Artificial Intelligence is actively being developed across the whole health-care spectrum, and its current applications include making further improvements in radiology by utilising computer-aided diagnosis, and also extending the capabilities of AI to enable surgical robots to undertake precision surgery. However, as Hippocrates quotes, “Healing is a matter of time, but it is sometimes also a matter of opportunity.” Technology has evidently created the opportunity and has consequentially improved our healing capabilities over a matter of time, but at what cost?
It is hard to not feel that, in spite all of these amazing technological advances, some of the core values that underpin being a great doctor, like kindness, human touch, and empathy, have been slowly eroded away in this process of constant innovation. I do wish that Hippocrates could perhaps have once again guided us through these changes with his wisdom. He would no doubt be challenging us to critically reflect on all of these rapid changes in technology and establish what price mankind has subsequently paid for them.
"Having a fulfilling life as a clinician is not just about the science of medicine but, equally importantly, is about the art of medicine, too."
Having a fulfilling life as a clinician is not solely about the science of medicine but, equally importantly, about the art of medicine, also. In fact, it is this dynamic combination of science and art that fundamentally makes being a doctor meaningful—especially given all the long hours labouring and studying all with the endeavour to help our fellow man.
I strongly sense that clinicians need to re-orientate themselves with their patients, by using, in the rather convoluted world we live in, the radically simple and low-cost approach of talking and listening to them. In the old days, doctors made accurate clinical diagnosis through undertaking a history, through carefully engaging and listening to the patient, and then would vigilantly and expertly use their hands to meticulously examine the patient by inspection, palpation, and percussion before finally using their stethoscope. The use of the doctor’s physical touch to demonstrate compassion and their employment of a combination of skills created a sense of security for anxious patients, and furthermore, strengthened the powerful and hugely meaningful interpersonal bond between doctor and patient.
Sadly, this bond continues to diminish as doctors disproportionately choose to rely on technology to deliver health-care services and overlook just how powerful a healing force listening and engaging can be, especially when combined with a kind approach. Strengthening this connection becomes of critical importance as the global population grapples with a rising burden of stress, anxiety, and other mental health issues. This added insight will thus help guide treatment and support all involved in a far more meaningful way, especially if enabled by sustainable use of technology.
Carlos Maria Galmarini talks about how the collective use of both human intelligence and artificial intelligence leads to wiser medicine. In my opinion, enhancing our care in this manner will also foster greater dignity for patients and allow more respect of their wishes while helping to develop a greater understanding of their families’ needs.
However, this reinforcement of the doctor-patient relationship can only begin in earnest by doctors once again adopting a kind and compassionate philosophy—one that can co-exist with these rapid technological advances. Couple this approach with a degree of humility and plenty of ability, and patients will be forever grateful.