A few years ago, a medical journal piece about electronic medical records with built-in “decision support” announced that the days of super-physicians and master diagnosticians were over.
Being a doctor isn’t very glamorous anymore, and being a good one seems rather obsolete with so many guidelines and protocols telling us what to do.
A hundred years ago, William Osler, a practicing physician, had single-handedly written the leading textbook of medicine, reformed medical education, helped create and chaired Johns Hopkins and become the chair of medicine at Oxford.
Today, it is virtually necessary to be a researcher to teach at a university, let alone chair a medical school. The only other way to advance in medicine is to go into administration. Leaders in medicine are not chosen for their mastery of clinical practice, but for their managerial or business acumen.
The culture of clinical excellence has few heroes in our time. Pharmaceutical companies sometimes speak of “thought leaders” on the local level, which is more often than not only their way of building momentum for their drug sales through promoting early adoption of new medicines. Doctors today practice on a level playing field, where we are considered interchangeable providers in large organizations and insurance networks. Media doctors don’t earn their position based on clinical mastery, but rather their communication and self promotion skills.
What happens to medicine when it has no heroes? Who defends the ideals of a profession that is becoming commoditized? What keeps new physicians striving for clinical excellence with only numerical quality metrics and policy adherence as yardsticks? How are the deeper qualities of doctoring preserved for new generations of doctors, and how are they kept in focus with all the distractions of today’s health care environment – because people still worry and suffer; they are more than bodies with diseases or abnormal test results.
Every day, doctors on the front lines treat two dozen fellow human beings with every imaginable condition. How do we carry on, with only our own ideals as beacons in the fog, if we are left to ourself to defend our higher purpose, without champions, mentors, or heroes?
A Country Doctor Writes: 
Country Doctor: You are one of my many physician heroes. As I approach first year of medical school next fall I will try to follow your wise counsel and seek out the type of mentors that you are describing. Although we’ve never met I look up to your example and your dedication to your patients. Thank you.
Please be assured there are many people who do not want computerized medicine where the humans are merely interchangeable parts, cogs in a great mechanistic contraption. For me, medicine has turned into a camel… you know that one: What’s a camel? A horse designed by a committee! May good sense and grace save us from committee medicine!
As Andrew Goates wrote earlier, you are one of my MD heroes. Along with other deep thinking healers, not all MDs… very few MDs in fact, but a few keep you company.
Perhaps the healers who wish to delve deeply into what it means to be a healer, what it means to walk a journey along side your patient, to know them well and see them in their totality without judgment, but with discernment… to explore what it means to be a human… perhaps those people will have to explore avenues other than conventional medicine. I invite them to consider oriental medicine, homeopathy, ayurvedic medicine, and more… those forms of medicine are harder to computerize and therefore harder for Mega-Pharma-Corporate-Computer-Medicine to mechanize.
Please do not despair. Please continue to walk your Path for the benefit of your patients and for us your readers. You inspire others with your work.