nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Friday, July 16, 2010

Medical Quote Of The Day - 16 July 10

  
"Our profession, after all, deals partly with guess work; we do not deal in absolutes."

-- Paul Beeson, M.D. [1910 - 2007]
 
 



 

2 comments:

The 50 Best Health Blogs said...

Then why do so many doctors expect their every word to be accepted without question or explanation? And why do they so often dismiss their own patients' complaints about side-effects as "anecdotal?"

It's hard for me to take a doctor seriously if he (or she) doesn't take me seriously.

Jim

Doc D said...

Jim, I sense your frustration but doubt I can give the answer you deserve in a short comment. No matter how they may talk, every doc knows we act on probabilities. No treatment is certain—people sometimes get well when they shouldn’t and others don’t when they should. The best among us know that failing to communicate that our knowledge is incomplete, or not addressing patients’ uncertainty, makes it that much harder to develop trust. Medicines alone don’t work as well as medicines plus trust and understanding. In the examining room, I look for signs that the patient isn’t following me, or doesn’t see the “why.” Some won’t say, unless you let them know you’re comfortable with hearing it. I was lucky enough early in my career--when I thought I knew everything--a couple of patients taught me “administering the sacrament of treatment” was disdainful and defeated my purpose. As a patient myself, I always make it clear to my doctors that I expect them to answer all my concerns, and if there isn’t an easy answer, tell me. I also expect to concur in all decisions. My friends say, “Well, you’re a doctor. They see you differently.” That’s true, but I tell them back, “If your doctor won’t take the time to develop trust and confidence between you (it works both ways) and doesn’t see you as a partner in the relationship, first, be open and say what you need. If that doesn’t work, get another doctor.” (Still, there are some patients that just want to be told what to do…everybody’s different)

In my military career I was a hospital commander 3 times. That made it a lot easier to set standards for how I expected my providers to conduct themselves. In civilian life, the patient has to be their own advocate—not in an ugly way, but a reasonable way. Try this: “Doc, I’m not the expert, so I need your help; this is serious, I need to understand what and why, and some issues are unaddressed.” If they don’t respond positively to that, they’ve forgotten what their job is.

That’s the practical side of the quote. Dr. Beeson was reminding his students of the principle that humans are unique, and too complicated for us to assume there’s always a single answer, or even a very good one. Penicillin doesn’t always work on strep throat, though that’s the best first choice. I make sure patients know there’s always a chance treatment will be ineffective. That’s my style. I have colleagues who think it’s better to express confidence.

Thanks for your comment.
D

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