Tuesday, April 4, 2023

It Changes, It Remains the Same: JAMA Quote (1923)

From JAMA, 3/28/2023, p. 1038.

"The rapidly developing appreciation of the importance of preventive medicine by the general public and by the medical profession has brought home to the medical school the problem of teaching disease prevention in its broadest sense....The practice of medicine has been changing for several years, and a steadily increasing trend in the direction of prevention, and earlier diagnosis and treatment.  

....The old-style family physician, formerly the ideal example, is passing...he is the victim of human limitations...and cannot come back...medical science has become too technicially comprehensive."

Written by S.R. Hawthorn, Univ. Pittsburgh, 1923.


See also a book review in the WSJ, 4/3/2023,  The new book is Dean & Talbot, “If I Betray These Words: Moral Injury in Medicine and Why It’s So Hard for Clinicians to Put Patients First,” the reviewer Dr. Rothstein quoting, "today’s physicians are “seeing more patients, in less time, with fewer support staff,” and are “required to use technology that interfere[s] with rather than facilitate[s] care.” As a result, our healers feel exhausted, cynical, alienated and ineffective.

In part, the book discusses financial pressures as mentioned also by Hawthorn in 1923.  Somewhere I have a book, The Doctors by Martin Gross, 1966, about how doctors of the 1950s and 1960s were only interested in Cadillacs and golf course memberships.  So some themes are perenniel.  I've also got a slide of quotes from middle-aged doctors of 1890s and 1920s saying this younger generation of doctors were only interested in technology.  And of course, those young doctors of the 1920s became the eminent patient-centered doctors of the 1940s saying that unlike themselves, here's this new generation who are only interested in technology and testing.  (The new Rothstein review has an 1894 quote on the interplay between doctors and hospital profits.)  


Quotes from William Harvey on how validity in science is debated and decided