Medicine as an Imperfect Science

Posted by Anthony Lee Jan 4, 2008

As the new Feature Writer for General Medicine. I would like to dedicate my first blog entry to something I see often: idealistic views of medicine. We all want the best doctors and the best care. We want it so much that not having an immediate diagnosis or being denied a test or treatment can be frustrating. However, are patients really aware of the other side?

With that, you may want to consider the following:

• Because medicine is still evolving, not all conditions have good screening tests and treatments.
• Sometimes, one condition is similar enough to another that even the best doctors can misdiagnose a patient.
• Some conditions are easily diagnosed without tests. Tests are only done when additional infomation is necessary and could ultimately change the treatment.
• Tests do not identify specific diseases, but they increase or decrease the probability of possible diseases.
• Tests are never 100% sensitive or specific to one disease, but good tests come fairly close.
• False positives and negatives are always a possibility with any test.
• Tests and treatments are accepted when proven, meaning the benefits must outweigh the risks.
• Advertisements for any treatment should be taken with a grain of salt.
• Good clinical studies, preferably randomized controlled trials, involve many people over a long period of time.
• Even with one good study, only multiple studies confirming the same results are truly convincing.
• Certain conditions are managed over several follow-up visits, not always in one visit.
• Doctors refer to specialists because no single physician can know everything.

Basically, understanding medicine involves not having idealistic expectations. The human body is not an artificial machine. Because we don't design people, patients aren't assumed to have the same inner workings that can be fixed based on a standard manual. Hopefully, with this perspective of medicine, you can be happy with your care no matter what happens.