The Pleiotropic Art of Medicine

Greg A. Hood, MD

Disclosures

July 06, 2015

In This Article

One Factor Has Multiple Effects

The practice of medicine is complex. It's an art. Art can benefit from the adoption of new technology, growing in its robustness and expression. Technology can spread access to both art and healthcare. But neither can grow in the face of inadequate standards or perverse incentives.

The healthcare delivery system has yet to face its sternest task: the full representation of the baby boomers within the Medicare-eligible ages. Yet, the shrinking prevalence of fully trained and experienced providers in primary care fields—and the yawning disinterest with which the average citizen and average politician or bureaucrat meets this indisputable fact—is cause for substantial, justifiable concern.

A Collective Overconfidence?

Before you leap to the conclusion that this position is a rant against the proliferation of nonphysician clinicians, please allow me to reassure you that it's not. In this moment, it's wise to consider the words of the poet and writer Charles Bukowski, who said, "The problem with the world is that the intelligent people are full of doubt, while the stupid people are full of confidence."

There are a great many care workers within primary care, including physicians, nurses, nurse practitioners, and physician assistants, who are knowledgeable, wise, and well-considered. The next time you talk to a healthcare provider, ask him or her how confident they feel about possessing the full knowledge base of medical wisdom. The self-aware and reasoned of us will tell you that although we may have deep, thorough knowledge of fields and aspects within medicine—and in particular healthcare delivery itself—there is still much that is, either on the individual or the collective level, not yet understood or proven, and areas that we feel less well-versed within. It's a fact of human existence. Unfortunately, many people will bluff and bluster to the contrary.

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