Medical Practice: The Art & Science

Let me just put this out there right away, if are a lay person or even a former health care professional such as myself, you do not have the same knowledge that physicians’ have. No matter how much you read, how well you comprehend, how many expert websites you check, people you talk to, or medical books you check, you do not know what doctors know. You just don’t.

It’s that plain and simple. During this past year we have had some of our traditionally most respected professions disparaged. Yes, I am talking about educators, law enforcement, and medical doctors. This post only concerns the last group, but much could be said about the others, as well.

Have you been to medical school? Or, through a medical residency program? Have you? If not, then you should not assume you know what our medical professionals know about diagnosis, disease, and/or treatment.

When I worked at Johns Hopkins Hospital in the early 1990’s as a nationally certified Pediatric Nurse Practitioner in the newborn nursery we had rotating attending physicians. They made rounds with us each morning on all the inpatient babies and moms on the postpartum unit and a few more “exotic cases” on the antepartum ward such as a woman who might have had malaria, and consultation was needed with other specialities such as infectious disease. As you can imagine, Johns Hopkins being a renowned hospital, drew both the elite in Baltimore County as well as many indigent families or women who had no pre-natal care prior to delivery. In truth, we had many, many cases of the later. And, as a result, I took care of babies that had neonatal abstinence syndrome, congenital syphilis, EhlersDanlos syndrome, Erb’s palsy, birth trauma, and diabetes. In a few words, it was NOT a normal newborn nursery. Of course, Hopkins had a Level III intensive care nursery for babies who were premature or critically ill at birth or became critically ill in the nursery, but we saw our fair share of disease and abnormality in the newborn nursery as well.

Our attending physicians were some of the most highly recognized pediatricians of the last century. It was my honor to work with them and hone my skills in caring for these babies and their moms. But, one of the most important things I learned during my time at Hopkins was this: medicine is not practiced with a cookbook.

Thus, you cannot (and should not) open a book, consult a website, or textbook and assume you know what doctors know. You just don’t. It is okay to take an active role in one’s health care and even in the care of your children and/or parents. But, the knowledge physicians have must be respected. Most of them, certainly the best of them, do not follow a cookbook in the diagnosis or treatment of any disease, no matter what their specialty. Each case needs to be considered individually from all angles. Sometimes, it does not matter what the test results say. Sometimes, there is more to a diagnosis than numbers. The practice of medicine is most certainly a science but there is an art involved in practicing as well. Ability to pick up nuances, read patients’ actual concerns despite what is being said, as well as telling the difference between a sign and a symptom are all essential parts of excellent medical practice.

Of course, this is my opinion, but I stand by it due to my own experience as well as the experience of physicians I know and have known in the past. The analogy goes further. If you use a recipe and follow it exactly, you know how sometimes it still doesn’t turn out? The same can happen in medicine. Therefore, let the doctors decide how to diagnose and treat you or your loved one. Give them the respect they deserve. There is no cookbook for the profession of medicine.

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