The discussion this past week on the tensions between public health and physicians representing evidence-based medicine bothered me. True, there may be tensions regarding the methods to administer help, but the intentions should still be the same...to improve everyone's quality of life. There should be a balance between prevention and treatment, for not all diseases can be prevented. Instead, we should focus on people as a whole, who's quality of life can many times, determine health status. Here' s a couple good quotes that summarizes these intentions:
“The quality of life is more important than life itself”
~Alexis Carrel
"What's wrong with death sir? What are we so mortally afraid of? Why can't we treat death with a certain amount of humanity and dignity, and decency, and God forbid, maybe even humor. Death is not the enemy gentlemen. If we're going to fight a disease, let's fight one of the most terrible diseases of all, indifference. "
"A doctor's mission should not just be to prevent death, but also to improve the quality of life. That's why, you treat a disease...you win, you lose. You treat a person, I guarantee you, you'll win, no matter what the outcome."
~Patch Adams
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I agree. It really bothered me as well. I think I had been naive in thinking that physicians and those in public health all wanted the same thing, that we are all on the same side. We should be on the same side, but I guess a lot of people don't see it that way.
Maybe we can change that?
The British Medical Journal just ran a very interesting feature of the 15 greatest medical advances since 1840 (http://www.bmj.com/content/vol334/suppl_1/) and included evidence-based medicine on the list...the write-up there briefly discusses the controversy surrounding evidence-based medicine...the bottomline both sides have valid arguments - proponents want everyone to follow standard practices and protocols based on best available evidence, and opponents argue that it would be wrong to straight-jacket providers and limit their options given the idiosyncracies of different patients who might therefore require quite different management approaches and the reality that the practice of medicine is still very much an art rather than a science.
Good change leaders look for common ground even when people disagree, and seek to build consensus on areas of common interest - not to try to impose their views with little or no respect for competing points of view...
"The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function."
F. Scott Fitzgerald (1896 - 1940), "The Crack-Up" (1936)
Wow, I really liked the Patch Adams quote! It reminds me of the philosophy behind Osteopathic Medicine. Osteopathic Physicians are fully-licensed medical doctors whose philosophy is to treat the person and not the disease. By doing so, you are taking care of the whole person and not just treating symptoms. Perhaps the best way at executing this mantra is to focus on preventive medicine (of course!). By treating the whole person, it is good to address some of the social issues involved with the person as well. Check out the website for the American Osteopathic Association at http://www.osteopathic.org/
Last semester we read an article about ethics and public health and doctors, I will find it and post it because it addressed some of the issues discussed here. It is frustrating because I think it slows our progress towards needed solutions when these two fields, that are so closely intertwined, butt heads. Can't we all just get along?? :) It seems like in general competitive nature often gets in the way of working towards common goals.
Cori, such a great blog...I really enjoyed reading it! I think in this hectic world Physicians have forgotten the second part of your blog " improving ones quality of life"...This is something that I hadn't heard of for a while. Specially by facing many daily public health issues internationally. I wish we had more future doctors that remember to think this way! I say this but I know some people might think there is so much problems in the world that we are so far behind form improving someone’s life quality.
Well that’s true as too! But I just like the concept and it make me think and feel more positive toward happy, healthy and peacefull future for every one, any where in the world!
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