Being an expert witness was an eye-opening experience that made me question the very essence of the “art” of medicine and its place in a world dominated by evidence-based medicine. The encounter I had while testifying in court reminded me of Viktor Frankl’s profound statement that “textbooks tell lies.” This article explores the significance of the art of medicine, the importance of understanding patients as individuals, and the role of empathy and compassion in healthcare.
Frankl and his fellow physicians at Auschwitz concentration camp discovered firsthand that medical textbooks were irrelevant in the face of unimaginable human suffering. The brutal conditions prisoners endured demanded an entirely different approach to medicine, one that textbooks of that era could never have predicted. The surprising resiliency of some prisoners and the unforeseen illnesses resulting from their suffering were not accounted for in the medical literature of the time.
As an expert witness, I found myself in a courtroom defending the art of medicine against an attorney who emphasized the importance of evidence-based medicine. I had to assert that there is much more to medical practice than what can be found in textbooks and journal articles. The knowledge gained from double-blinded placebo-controlled studies only scratches the surface of understanding a patient’s health and well-being.
The art of medicine demands a deep understanding of a patient’s history, including their social and psychological factors. It necessitates knowing the patient as a whole person, not just as a collection of symptoms. For psychiatrists, this understanding goes even deeper, delving into their patients’ relationships, emotions, and personal experiences. This kind of knowledge cannot be acquired solely from textbooks or guidelines.
The art of medicine is rooted in treating patients with empathy and concern. Acknowledging and understanding a patient’s feelings can greatly impact their healthcare experience and outcomes. It requires healthcare providers to go beyond the biomedical model and consider the mental and emotional aspects of a patient’s well-being. The art of medicine recognizes that healing goes beyond physiological factors.
In the case I was involved in, the insurance company doctors failed to consider the unique circumstances of the patient. Their decision to deny necessary treatment based solely on guidelines demonstrated a lack of understanding and compassion. This type of decision-making can be seen as practicing medicine in bad faith, as it neglects the fundamental principles of the art of medicine.
To provide effective medical care, both the art and science of medicine are essential. The science of medicine offers evidence-based solutions and tools for diagnosis and treatment. It provides a solid foundation for medical practice. However, the art of medicine complements the science by focusing on the individual, recognizing their experiences, and building a therapeutic relationship based on empathy and compassion. The art of medicine ensures that patient care is not reduced to a mere checklist of symptoms and treatments.
The art of medicine is a vital component of healthcare that should not be overshadowed by the dominance of evidence-based medicine. It demands understanding patients as individuals, treating them with empathy, and acknowledging their unique circumstances. Medical textbooks and guidelines only provide a fraction of the knowledge necessary to practice medicine effectively. As healthcare professionals, we must embrace the art of medicine and remember that healing requires more than just scientific knowledge.