DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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What makes a great doctor?

I love the answers that both physicians and non-physicians have posted in response to my questions last week. Over the next few days, I plan to synthesize the responses in a new entry.

As I have thought about the issue, I remembered a wonderful book that I read many years ago – The Effective Clinician by Dr. Philip Tumulty (published in 1973). I am not the only one who remembers this book. SECOND OPINION: Know any great doctors?

What does it take to be a great doctor? William Osler said, “The good physician treats the disease; the great physician treats the patient who has the disease.” In describing the model clinician, Dr Philip Tumulty wrote:

He is meticulous in accumulating the historical and physical data from the patient. His questioning of the patient is searching and incisive, like that of a wise barrister. . . . His special interest is any human illness. His care of the patient does not end with the correct diagnosis. . . . He is inexhaustibly capable of infusing into his patients insight, self-discipline, optimism and courage. Those he cannot make well, he comforts. . . . The things he works with are intellectual capacity, unconfined clinical experience and the perceptive use of his eyes, ears, hands and heart.

How often do we provide that kind of doctoring? Most of us, I suspect, accomplish this only occasionally. Yet we all strive for excellence. It seems easy to summarize what’s needed—maintaining an up-to-date knowledge base and using that knowledge in a skillful and caring fashion—but it requires continued learning and diligent application to truly be “a great doctor” with more than just the occasional patient.

I find these quotes very consistent with the ideas that you, the readers, have expressed.

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