The Lesser “Personal” Side of Medicine

A century-old tidbit of wisdom from the Book on the Physician Himself by DW Cathell MD (published way back in 1902, so ignore the pronouns):

EVERY Medical Man discovers sooner or later that The Practice of Medicine has two sides: A Greater Scientific Side, and a Lesser, but important, Personal Side, and that to fight the battles of life successfully it is as necessary for even the most scientific physician to possess a certain amount of professional tact and business sagacity as it is for a ship to have a rudder.

Only one of these sides is meaningfully taught or modeled in school, and I think we’ve all met physicians who do not seem to possess “professional tact” or “business sagacity” and been worse for it. Cathell was writing during a time when most physicians literally were one-man shops, but if anything the “lesser” side of the Practice of Medicine is more important than ever.

Discussing the ancient pro/cons of specialization that led to ever-increasing specialization over the next 120 years:

You may also ask the question: Shall I adopt a specialty? Would it pay me to do so? The adoption of a specialty, to the exclusion of other varieties of practice, is successful with but a few of those who attempt it. It should never be undertaken without first studying the whole profession and attaining a few years’ experience among the people as a general practitioner.

A successful specialist has many advantages over the hurly-burly life of the general practitioner: He is independent of general practice. He has short hours and is seldom or never called out at night. He can escape the expenses of horses, carriages, stables, and drivers. His Sundays are his own if he chooses. His fees are always good, sometimes fat. He can tell his terms and arrange about the payment of his fees at the beginning of each case, and usually gets them cash, and after a much easier life he generally dies a great deal better off pecuniarily than the general practitioner.

On the other hand, the specialist must be better equipped in instruments, etc., and more dextrous and masterful in their use and also more concise in the details of treatment; should possess a faultless manner and must foster his practice more carefully; in other words, if you put all your eggs in one special basket you must watch that basket much more closely.

So much energy has been spent fighting in the turf wars of watching and growing those special baskets that doctors dropped the ball on the broader healthcare basket entirely.

Dying rich after an easy life sounds nice, but he did miss the part where the physician became an employee and stopped being able to choose those short hours and Sundays “as his own.”

(Hat tip @archives_Rx.)

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