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
There is a common tendency to attempt to select assistants in a
department of medicine whose training represents the different
preclinical sciences, physiology, organic chemistry, physical
chemistry, physics, bacteriology, so that one may have a well rounded
clinic. There is obviously much to be said in favor of such a plan
as it helps to bring together an experienced group of “scientists”;
but there is also an inherent practical danger which I am sure we all
have observed and to which more attention should be paid. These men,
thoroughly trained in one direction, quite naturally look for their
research problems in the fields in which they are trained. They seek
the problem to suit their particular tools. This must necessarily be
the attitude of workers in a fundamental science when they attempt
to study a clinical problem, and this may explain why they often are
not more successful in formulating and working out problems involving
a knowledge of disease in man. The approach of the internist to the
study of disease in man should be quite different. He is, first of
all, absorbed by an interest in the problem and then seeks the type
of tools necessary to solve it. This is the intellectual, rather than
the technical, method of approach. Once given an absorbing passion for
the solution of a clinical problem, the man who has a good, general
scientific training can usually acquire in a few months or in a year
or so enough of any of the fundamental sciences to enable him to
tackle it. The clinical investigator, with his knowledge of disease
in man, thus finds the problem first and determines the practical way
to study it, turning to his colleagues in the fundamental sciences
especially for technical experience. We often discuss what the
difference is between the function and opportunity of the man who is
primarily a “scientist” working on a clinical investigation, and the
man who is primarily an “internist” using methods of exactly the same
highly refined nature, and also working on the same general type of
investigation. The real difference is, I think, to be found in the
point of view. The medical clinic should encourage its staff to use
methods of any sort, no matter how difficult or specialized, that are
needed for the solution of their immediate problems; but their first
interest should center about the general subject of disease in man.
The first interest of the “scientist,” on the other hand, is in the
development of his own particular field. Each has his proper rôle, but
in the medical clinic it is better to have an inspired “internist” than
a skilled “chemist.”
Public-domain text, read in full here on John Shaqi.
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