Doctors Differ: A Philosophical Perspective

 

Dr. Kamala Kant Bhoi ¹

 

¹ MBBS, MD(Medicine), DM(Neurology), Neurologist, Assistant Professor, Shri Balaji Institute of Medical Sciences, Raipur, Chhattisgarh, India

 

1. INTRODUCTION

The phrase "Drs differ" acknowledges the inherent uncertainty and variability in medical practice. Different healthcare professionals may have varying opinions, interpretations, and approaches to diagnosis and treatment.

 

1.1. Case Studies

Case 1: Personal Experience

A personal experience highlights the complexities of medical decision-making. The author's mother experienced headaches at elevated blood pressure levels of 130/80 mm of Hg from the base line of 110/70 mm of Hg, despite being within normal ranges. Initially, it was thought to be a migraine, as it sometimes responded to anti-migraine medication. However, she had a mild heart attack two months prior, which necessitated blood pressure medication.

Case 2: Clinical Experience

A clinical experience further illustrates the uncertainty and variability in medical practice. A patienty had a sugar level of 400 mg/dl, which decreased to 200 mg/dl, resulting in unconsciousness. Consequently, the decision was made to maintain higher sugar levels. The patient passed away due to a head injury, without experiencing kidney failure or a heart attack.

 

2. Philosophical Reflections

The primary goal of treatment is to prevent severe complications and prolong life without excessive suffering. This raises important philosophical questions about the nature of medical knowledge, the role of expertise, and the importance of patient-centered care.

 

2.1. Key Principles

1)    Justice: Ensure that punishment is administered correctly, and wrongdoers do not escape.

2)    Medicine: Minimize harm to both normal and diseased individuals.

 

3. Review of Literature

Research highlights the inherent uncertainty and variability in medical practice [Charles et al. (1997), Fox (1957)]. This uncertainty can lead to variations in care, emphasizing the need for patient-centered approaches [Gawande (2002)]. Medical decisions are influenced by personal experience, cultural background, and social norms [Institute of Medicine. (2001)]. The increasing complexity of medical knowledge and technological advancements contribute to uncertainty and variability [Kleinman (1980)]. Effective communication and shared decision-making are crucial [Timmermans & Berg (2003)].

 

4. Discussion

The case studies demonstrate the complexities of medical decision-making and the importance of patient-centered care. Uncertainty and variability exist in medical practice, highlighting the need for nuanced understanding and effective communication. Healthcare professionals must consider individual patient needs and circumstances when making medical decisions. Furthermore, the increasing complexity of medical knowledge and technological advancements contribute to uncertainty and variability. Therefore, healthcare professionals must stay up-to-date with the latest medical knowledge and technological advancements while acknowledging the limitations and uncertainties of medical practice.

The importance of patient-centered care cannot be overstated. Patient-centered care approaches prioritize individual patient needs and values, and involve patients in the decision-making process [Timmermans & Berg (2003)]. This approach can help reduce uncertainty and improve health outcomes.

Moreover, patient-centered care promotes a collaborative relationship between healthcare professionals and patients, leading to better health outcomes and increased patient satisfaction.

In addition, the role of expertise in medical decision-making must be acknowledged. Healthcare professionals must balance their expertise with the unique needs and circumstances of each patient. This requires effective communication and shared decision-making, as well as a willingness to adapt to changing circumstances.

 

5. Conclusion

In conclusion, the phrase "Drs differ" acknowledges the inherent uncertainty and variability in medical practice. By adopting patient-centered care approaches and acknowledging uncertainties, healthcare professionals can provide high-quality care prioritizing individual needs.

 

CONFLICT OF INTERESTS

None. 

 

ACKNOWLEDGMENTS

None.

 

REFERENCES

Charles, C., Gafni, A., & Whelan, T. (1997). Shared Decision-Making in the Medical Encounter: What does it mean? (Or, it takes at least two to tango). Social Science & Medicine, 44(5), 681-692. https://doi.org/10.1016/S0277-9536(96)00221-3

Fox, R. (1957). Training for Uncertainty. In R. K. Merton, G. Reader, & P. L. Kendall (Eds.), The Student-Physician (pp. 207-241). Harvard University Press.

Gawande, A. (2002). Complications: A Surgeon's Notes on an Imperfect Science. Metropolitan Books.

Institute of Medicine. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press.

Kleinman, A. (1980). Patients and Healers in the Context of Culture. University of California Press. https://doi.org/10.1525/9780520340848

Timmermans, S., & Berg, M. (2003). The Gold Standard: The Challenge of Evidence-Based Medicine and Standardization in Health Care. Temple University Press.