Welcome To The World of The Masters of The Clinical Arts
The marvels of modern scientific and
technological medicine are taking over and pushing the clinical arts out of
existence. Young doctors are learning to rely on that science and technology
rather than their clinical skills and acumen. They are delegating
responsibility to the tests and protocols rather than taking that
responsibility themselves. They are losing confidence in their clinical skills
and arts. Developing those skills and arts is less important to them; they are
no longer a matter of life and death. That responsibility can be left to a
machine or computer protocol.
That luxury was not available to the retiring
generation of doctors when they trained and first practiced. Medical science
and technology was in its infancy in the fifties and sixties. They only had
plain x-rays and primitive, basic blood tests. There were almost no machines in
hospitals, only human clinicians. There was nothing non-human to delegate
responsibility to. Human doctors had to take that responsibility. There was no
substitute for the clinical arts and they had to be developed to their
pinnacle.
The past masters of the clinical arts learned
their art first as a necessity. It was their foundation. As the science and
technology came along, they were added gratefully to the doctor’s diagnostic
and therapeutic armoury. They were kept in context with the pre-existing
foundation of the clinical skills and acumen and perfected clinical practice.
The human doctor still had overall responsibility and the science and
technology were the tools that served them.
The masters of the clinical arts is fascinated
and enamoured with the science and technology of medicine and how it can
improve their clinical practice. Still, they hold it in the context of its only
being a fragment of a greater picture that is painted by their art. It is still
their servant.
This is more subtle than an either/or question
of the clinical arts versus the science and technology of medicine. The mastery
of the science and technology of medicine is one of the essential arts of
medicine to form a synergistic and harmonious relationship between human and
machine where the human is still in full control of their mechanical tools.
Their master uses their tools as any craftsman, precisely and sparingly, only
where necessary.
That confidence and ability is being lost at a
time that it is more important than ever. Every scientific and technological
investigation or treatment is known to carry a measureable risk, either a
direct risk or an indirect on caused by further investigation and over-treatment.
They must be used sparingly and only when they do more harm than good.
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