D epartment
of
M edicine
Con ne c ti ng T e c h n o lo g y , Ed uca t i o n a n d D i s cove ry w ith H um anis m in Me dicine
Vol. 4 Issue 2 April 2015
Keeping the Human in Medical Humanities The term “medical humanities” is much like “medical sciences,” easy to recognize but difficult to define. Medical science is an amalgam of many things, biochemistry, microbiology, anatomy, physiology, but no one expects a physician to be a bench scientist in order to practice medicine. The name medical humanities is even more amorphous. It
originated in the 1960s in a religious context promoted by theologians and bioethicists as an effort to humanize medicine, which some thought had already started its pivot away from the patient and toward technology. It has since incorporated philosophy, anthropology, sociology, psychology, and the arts; music, literature, poetry, and drama. All of these fit well under a humanities classification, but the relationship to medicine is less obvious. People often call on it when trying to describe a perceived deficit in the persona of today’s physician, equating it with that special blend of bedside manner and clinical concern that evokes a Norman Rockwell image. That is not a fair comparison. There are generations of doctors who inspire confidence and trust, who make home visits on winter nights and bandage little boys who have fallen out of apple trees but have never been to an opera, never read a poem, and find the rendering of a coherent progress note painful. There are others, as real as the fictional television Dr. House who are gifted with a scintillating intellect and frightening diagnostic abilities, who play the guitar and piano, who hang out in art museums, yet demonstrate egregious behavior toward patients. Educators argue that studying the arts can transform the impersonal medical scientist into a compassionate, competent practitioner by rekindling the dying embers of empathy. They see unique opportunities to hone clinical abilities by exploiting the similar skills needed to read a literary manuscript and a patient. They suggest that there is an opportunity for young
Robert Thom, American 1915-1979 “Pasteur: The Chemist Who Transformed Medicine,” from “The History of Medicine” Courtesy the Collection of the University of Michigan Health System, Gift of Pfizer Inc., UMHS.32
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Points of View
morphed into information technology-supported pathways of clinical practice. The provision of medical care is highly dependent on several correct steps occurring in the right sequence at the right time, and clinical pathways help to systematize these steps in an appropriate manner by developing computer-based, comprehensive patient/disease specific care plans. Our hospital’s leadership has vigorously embraced clinical pathways for the most common illnesses seen at our center. A major concern with routine use of order sets and clinical pathways is that they limit clinicians’ ability to act independently, and their widespread adoption could lead to “cookbook medicine” by discouraging clinicians’ knowledge and understanding of the logic and evidence on which the recommendations are based. On the contrary, development
Learning Aspects of Pathways The emphasis on quality assurance, evidence-based medicine and clinical quality improvement that began in the late 1980s remained a focus of attention through the first decadeand-a-half of the new millennium and will hopefully continue for the foreseeable future. Regulatory bodies, Rajiv Dhand, MD, Chair professional societies and consumers of health care are stressing the need to standardize clinical practice across the spectrum of patient care. In this environment, guidelines for the management of specific disorders have proliferated and have progressively
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