The Finest Traditions of My Calling: One Physician’s Search for the Renewal of Medicine

For more than a century, veteran physicians have written reports deploring the state of their profession, and in this earnest account, Nussbaum, director of adult inpatient psychiatry at Denver Health, argues that doctors have become unfeeling scientists dedicated to efficiency and income. He says that medical schools, aware of the problem since the 1990s, have begun teaching ethics, cultural sensitivity, and communication, as well as assigning readings outside of medicine. Nussbaum sees these efforts as admirable, but he suggests this attempt to produce physicians who are both scientists and humanists reinforces their distance from patients, whom they should see as suffering fellow humans. Nussbaum describes current campaigns for evidence-based treatments, checklists, quality-improvement guidelines, and reduced hours for residents as misguided efforts to apply industrial standards to medicine. These efforts aim to improve outcomes (i.e., increase patients’ chances of survival, reduce mishaps) at the expense of care. Nussbaum maintains that medicine differs from all other industries, and that the way a doctor cares for a patient matters more than the outcome. Patients might value outcomes more, but they certainly yearn for the respectful, empathetic treatment that Nussbaum proposes and that is so often lacking. His insightful polemic reveals that current reforms in medicine are missing an essential element. [em](Apr.) [/em]