More on the problematic narrowness of thinking among some medical practitioners

I put up yesterday an article by the excellent Arnold Kling in which he bemoaned the narrow vision of many doctors under the present system. I reproduce below an email that I have received in response from an American anesthesiologist -- in which he highlights current medical training as the problem

Concerning your column about the man looking at his father's medical care and "specialists not looking at the whole patient", let me tell you about my experience.

Surgical Residents (trainees) where I trained - were GREAT DOCTORS. There was a tradition of being harassed if they missed a lab value or physical sign - it's called PRIDE AND COMPETITION. They would be harassed at Grand Rounds if they missed something basic - like a skin rash or an abnormal lab value.

It's just nonsense to believe that SPECIALIZATION makes doctors too focused - it's the individual training program.

In another location, surgeons are "sloppy" - they are more concerned about what they are cutting, and less about the patient. Some specialists are the worst offenders. They have a stunning disregard for "the whole patient". Shameful.

In contrast, the best "real doctors" I have worked with in surgery were trained in a central Texas institution. All were good "doctors" and I miss them; I have yet to come across surgeons who have such a grasp of the "whole patient". But these are proof that it doesn't take a "family doctor" to act like Marcus Welby.

Anesthesiologists often "bail out" surgeons who are completely unaware of some of patients' serious medical problems. We are often called the "Internists of the Operating Room". We look at the "whole patient" as much as anyone, despite being "specialists.

It's not about IQ, or "specialization" - it's about the ATTITUDE of the director of the training program.

PS - My wife had surgery at this same central Texas institution; the recommendation of my colleague who trained there was good enough for me. Knowing the "inside" "is one of the perks of being "In the business".







Fatally negligent government X-ray service in Australia

A Gold Coast breast cancer sufferer who sued Breast-Screen Queensland over botched mammogram readings has died, but her grieving husband has vowed to fight for answers about the bungle. Philippa Naismith was diagnosed with aggressive breast cancer in July 2005 - 11 months after being given the all-clear by the state's breast-screening service. The cancer spread to her bones and she died at home on January 18, aged 54, with her husband Paul at her side.

Before she died, Mrs Naismith won a confidential out-of-court settlement from BreastScreen Queensland. Another Gold Coast victim's claim is still being finalised. The settlement followed revelations that Queensland Health had been forced to review 9300 women's mammograms after five radiologists contracted to BreastScreen had failed to detect some cancers.

Mr Naismith said yesterday that he was determined to ensure those responsible were held accountable. "Philippa died an absolutely horrendous death - she was coughing up lung tissue in the end - and I feel very angry," he said. "Presumably, these people are still working in the health system but they are not being made accountable for the lives they are supposed to protect. I'm not saying they gave my wife cancer but I am saying they took away any chance she had."

Source