Doctor and patient : $b Papers on the relationship of the physician to men and institutionsPeabody, Francis Weld
Science
Doctor and patient : $b Papers on the relationship of the physician to men and institutions
Peabody, Francis Weld
Medicine; Medicine -- Practice; Physicians
Quite possibly your comment on this will be that the symptoms of
such “neurotic” patients are well known, and they ought to go to a
neurologist or a psychiatrist and not to an internist or a general
practitioner. In an era of internal medicine, however, which takes
pride in the fact that it concerns itself with the functional capacity
of organs rather than with mere structural changes, and which has
developed so many “functional tests” of kidneys, heart, and liver,
is it not rather narrow-minded to limit one’s interest to those
disturbances of function which are based on anatomic abnormalities?
There are other reasons, too, why most of these “functional” cases
belong to the field of general medicine. In the first place, the
differential diagnosis between organic disease and pure functional
disturbance is often extremely difficult, and it needs the broad
training in the use of general clinical and laboratory methods which
forms the equipment of the internist. Diagnosis is the first step in
treatment. In the second place, the patients themselves frequently
prefer to go to a medical practitioner rather than to a psychiatrist,
and in the long run it is probably better for them to get straightened
out without having what they often consider the stigma of having been
“nervous” cases. A limited number, it is true, are so refractory or
so complex that the aid of the psychiatrist must be sought, but the
majority can be helped by the internist without highly specialized
psychologic technic, if he will appreciate the significance of
functional disturbances and interest himself in their treatment.
The physician who does take these cases seriously--one might say
scientifically--has the great satisfaction of seeing some of his
patients get well, not as the result of drugs or as the result of the
disease having run its course, but as the result of his own individual
efforts.
Public-domain text, read in full here on John Shaqi.
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