15 Medical
Practice
Physician-patient relationship
Clinical skills
Diagnosing disease
Patient care
Assessing treatment
Accountability
Guidelines to practicing medicine
Teaching and research
Types of practices
Professional hazards
Physician remuneration
Many years of study, a long interval of
training, and a lifetime of dedicated service are
required in order to become a good physician. It
is therefore essential that a premedical
student have an overview of the nature of the
medical profession. This can be accom-
plished in a number of different ways, including
(1) reading about the activities of med-
ical students, physicians-in-training, and those
in practice (see bibliography); (2) talking
with medical students and doctors; and (3)
performing volunteer work in a hospital.
This chapter seeks to supplement the
aforementioned approaches by discussing the
most basic elements of medical
practice.
The practice of medicine is a combination of
both science and art. The scientific
component involves the application of
technological modalities in solving clinical
problems. This requires the judicious use of
(1) biochemical methods, (2) biophysi-
cal imaging techniques, and (3) therapeutic
modalities--areas that have seen remark-
able advances over the past decade. Competence
in utilizing these areas, while essen-
tial, does not meet all the requirements of a
good practitioner. What is needed, in
addition to the aforementioned elements, is the
ability to extract vital information
from a mass of contradictory signs and
computer-generated data in order to arrive at
a tentative diagnosis and determine an
appropriate course of action. This involves
deciding whether to actively pursue a clinical
clue or merely to continue observing
as well as judging, if treating the condition
involves a greater risk than not treating it
at all. This combination of knowledge,
judgment, and intuition is the key to the art of
medicine.
Medical practice requires scientific knowledge,
technical skill, and human under-
standing. The last quality involves treating
the patient with tact and sympathy and real-
izing that a patient is a human being, not
merely a collection of symptoms, damaged
organs, and/or disturbed emotions. The
physician must recognize that the patient is, at
the same time, fearful and hopeful, and in need
of relief, assistance, and reassurance. To
meet this challenge, the physician must
genuinely care for people.
PHYSICIAN-PATIENT RELATIONSHIP
As stated above, physicians must recognize that
patients are not the equivalent of cases
or diseases; they are individuals, whose
problems often transcend the complaints they
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