Medicine: Art or Science

It is often said and acknowledged that physicians are trained in the Sciences to practice the art of healing. This underlines the importance of social and practical skills in medicine. In all fairness, Doctors are taught interpersonal skills in addition to the growing knowledge in the biomedical Sciences. Procedural skills which are acquired later on in the medical training are more of an art--due to the motor component of and personalized touch to it--though there is a scientific basis, to all of them, which is founded on the Sciences learnt in the earlier phase.

Without doubt, in the absence of scientific knowledge, medical judgement would be hollow, action to take conjectural and prediction of outcomes speculative; eventual complications would be misconstrued and mismanaged.

Most medical treatment is medication-based and there is lot of Science involved in drug discovery,  manufacture, action, use and complications thereof. Surgery is Science-based but its practice is more of an art, with the scientific knowledge held just at the back of the head, ready to be retrieved when needed to make informed judgement.

Many medical situations are self-limiting and resolve even without treatment. So, much healing will still occur in spite of some inappropriate treatment. The body has a way to compensate for failing function until decompensation sets in, when the system eventually becomes overwhelmed. However, by far, a major factor, which sets highly acclaimed and patient-approved doctors apart, is their connectivity with their patient--procedural skills assumed.

Perfect surgery is one thing; healing thereafter is another. A painkiller is another story and anxiety suffered during a procedure is yet another.

Experienced hands have known how body language and touch affect the psyche of their patients. Being comfortable in the company of your doctor helps in the healing process and makes much of a difference in the patient's disease outcome.

Light touching at certain body locations and inter-personal bonding stimulate the parasympathetic vagus nerve, which modifies the physiology of the body, alleviates many disease symptoms and drives the healing process through reflexes. No doubt, most patients get attached to their highly rated, drama-free Doctor.

A pat on the back, a handshake, or a massage to generate heat and alleviate poor circulation before performing, say, phlebotomy are some mannerisms that are practiced in the hospital setting. Doing some of these simple things and explaining the 'why' to the patient are a golden opportunity for the physician to instill trust, enhance the patient-doctor connectivity and raise the level of patient care.

Then there is the placebo effect. Trusting the attending physician and approving of the physician's demeanor all play a role in disease outcome. The brain Chemistry changes in response to physical cues;  olfactory, tactile, visual and auditory. It's said that our perception determines our reality, for a reason.

Dr. Oliver Verbe Birnso, MD.