The work of physicians with individuals and communities: Epidemiology and other partners in evidence-based medicine
Milos Jenicek in Foundations of Evidence-Based Medicine, 2019
For pragmatic reasons, medicine is often dichotomized as ‘clinical’ (i.e. pertaining to a clinic or bedside, founded on actual observation and treatment of patients as opposed to the theoretical or basic sciences) or ‘community-based’, pertaining to the body of individuals living in a defined area or having a common interest or organization (or characteristics).176 However, all types of medicine must be ethical. They must make a distinction between right and wrong. To solidify this, physicians entering the profession must take the Hippocratic Oath: A commitment to the ideals of medicine. Table 2.5 compares a classical Hippocratic Oath180 (from many of its versions) and its extension to cover other health professions.180,181 Several components of the Oath are highlighted to indicate those commitments that are very difficult to meet without the contributions of the various fields described in this chapter.
The Boundaries of Medicine
Dien Ho in A Philosopher Goes to the Doctor, 2019
One of the main goals of medicine is to improve the health of individuals. This much, it seems, is indisputable. But what exactly constitutes medicine? There are many ways to improve someone’s health. A 2012 study suggests that individuals who obtain college degrees after the age of 25 have lower risks for depression and better self-rated health (Walsemann, Bell, & Hummer, 2012). Although completing a college degree seems to be correlated with better health, it would be odd for a physician to recommend that patients enroll in a college or university to stave off mid-life depression. The reason is not the lack of a robust causal connection between education and health. For a doctor to recommend higher education as a prophylactic against depression seems professionally inappropriate.1 We want physicians to practice medicine. Just because something improves your health, it doesn’t follow that it falls within the domain of medicine.
Making moral decisions
Ira Bedzow in Giving Voice to Values as a Professional Physician, 2018
There are two general professional goals of medicine, (1) to improve a patient’s physical condition and (2) to improve his or her quality of life. These two primary goals will sometimes be in conflict, such as in cases relating to end-of-life care, yet they are oftentimes complementary. For example, improving a patient’s health will often lead to the patient having a higher quality of life. Conversely, tending to the psychological and social aspects of a person’s life will have positive results on his or her health. Even though these primary goals speak about “a patient” in general, one should not think of patients as simply opportunities to fulfill one’s professional goals. Your patients are not simply a means for you to practice your clinical skills and to improve your professional abilities; caring for particular patients is the goal in itself. The personal relationship between physician and patient is what creates the goals of medicine and is what gives them value. Keeping this in mind will influence how you approach professionalism and the people for whom you care.
The peer perspective: Why medical students should actively contribute to medical education
Published in Medical Teacher, 2021
Jessica Ying-Yi Xie, Anush Shashidhara
Medicine is a broad discipline, encompassing clinical Medicine, science, research, public health, policy and academia. Medical education is the lifelong process of gaining knowledge and refining skills related to Medicine (Swanwick 2013); it teaches students and doctors how to provide safe, person-centred and comprehensive clinical care for patients, the importance of keeping up-to-date with the latest research and awareness of social determinants of health. Medical education is a continuum; it must be constantly adapted to ensure students and doctors receive training that improves their abilities to meet the care needs of patients. This personal view will discuss our lessons learned from contributing to medical education as students and why we encourage all medical students to also become involved.
Localized, on-demand, sustained drug delivery from biopolymer-based materials
Published in Expert Opinion on Drug Delivery, 2022
Junqi Wu, Sawnaz Shaidani, Sophia K. Theodossiou, Emily J. Hartzell, David L. Kaplan
The field of medicine depends on therapeutics to treat or cure diseases. In 2020, it was estimated that $1.3 trillion was spent globally on prescription drugs [1]. As more therapeutics are developed, there is an opportunity for refined modes of delivery to increase safety and efficacy. With any mode of drug delivery, the active pharmaceutical ingredient (API) should be delivered at a concentration that reaches the therapeutic index, which describes the dose range where a medication is effective without causing adverse effects [2]. This concentration can be challenging to achieve due to unpredictable drug release rates, the inability to precisely target the desired tissues, renal/hepatic clearance of the delivered drugs, and unreliable stability of the therapeutic [3]. As a result, when therapeutics are delivered systemically, they often must be delivered at much higher concentrations than the target requirements to achieve an effective dose (Figure 1), leading to adverse side effects or harm to other organs.
Defensive Medicine and the Imposition of a More Demanding Standard of Care
Published in Journal of Legal Medicine, 2019
Vera Lúcia Raposo
However, despite some good results achieved by defensive medicine, this practice should not be adopted by doctors. The ultimate goal of medicine is to reach a balance between a standard of care that is sufficiently demanding to protect patients but is not so demanding that it inhibits timely medical response.37 More medicine is not necessarily good medicine.38 Excessive caution and demand may be formally correct but substantially incorrect. The practice of medicine could ultimately be jeopardized, with every doctor believing that if all possible conditions are not tested for the standard of care could be violated. Medicine could become an endless path of examinations, treatments, and follow-up, just because something could happen to the patient 20 years from now.39 At best, these could simply be useless. At worst, they could effectively damage the patient’s health and even his or her life.
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