drsharadpaul.com Saving Doctors from Themselves: Designing Medicine with Empathy and Compassion
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SavingDoctorsfromThemselves:DesigningMedicinewithEmpathyandCompassion
UTOPIAORDYSTOPIA?VISIONINGTHEFUTUREOFHEALTH
”InAustralia,“goingwalkabout”referstoariteofpassagethattheAboriginalpeopleundertake—atimeofsolitudespentsearchingfor“songlines”oftheirancestors—theideabeingtoimitatethepastandreturnwithrenewedenergytofacethefuture… That’swhysonglines matter;ourhistorymakesusmorethanwemakehistory.”~SharadPPaul,TheGeneticsofHealth(SimonandSchuster)
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drsharadpaul.com
"Studentsundergoaconversioninthethirdyearofmedicalschool- notpre-clinicaltoclinical,but pre-cynicaltocynical."~Abraham Verghese
Pattern-recognizers
Proceduralists
Personal-physicians
ALGORITHMS:MELANOMADIAGNOSISEDUCATION
“Thereareinfacttwothings,scienceandopinion;theformerbegetsknowledge,thelatterignorance”~Hippocrates
“…Thepublicwouldbeshockedifitknewtheamountofunnecessarysurgeryperformed”~ HawleyP,DirectoroftheAmericanCollegeofSurgeons(ACS),1953
“Weperformsurgerybecausewehavebeentrainedtodosoandbecause“wehavealwaysdoneitthisway” orwesimplydonotknowanybetter.InGermanpsychology,thisbehaviourisanalogoustoahistoricentitytermed“Funktionslust”~ Stahel PF. Blood,sweatandtears— becomingabettersurgeon.Shropshire,UK:TFMPublishing;2016.p.320
“Whenspecialistsarepaidthroughafee-for-systemschemeratherthanonacapitationbasis,surgeryratesincrease78%.Theimpactofprimarycarephysiciancompensationonsurgeryratesdependsonwhetherornotreferralrestrictionsarepresent”~Shafrin J.HealthEcon.2010May;19(5):562-80
SurgeryasTherapy:ACommonsenseApproach?
Ifwetreatedsurgerylikeapharmaceuticaldrug,theprocedurewouldberequiredtoundergoscrutinyoftestingitssafetyandfeasibilityinphase1and2trials.Subsequently,itsefficacywouldhavetobeproveninprospectiverandomizedcontrolledtrialspriortoapprovals.
Yet,theFDAorsimilarbodiesdo not regulatesurgicalprocedures.Regulationisrather“self-certification”viaprofessionalColleges.
Iflevel1evidencedisprovesabenefitforacertainsurgicalprocedure,anyineffectivepracticewouldbecalledintoquestionandabandonedimmediately.Thisisnotthecaseinthefieldofsurgery.
Perfectionists(“Imustdothisright,mistakesareintolerable”)Narcissists(“Iamthegreatest”)Compulsives(“Imustdothis,andIcan’tgiveuptillIfinish”)Denigratorsofvulnerability(“Peoplewhoneedhelparefailures.IfIneedhelp,Iamafailure”)Martyrs(“Icareformypatientsmorethanmyself,andmyneedsaresecondarytothoseItreat”)
Whendoctorsneedtreatment:ananthropologicalapproachtowhydoctorsmakebadpatientsAlex Wessely, Clare Gerada ,12Nov2013
“Letfoodbethymedicineandmedicinebethyfood”~Hippocrates
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“Wherethereisloveofhumanity,thereisalsolovefortheartofmedicine”~Hippocrates
MyRegisteredCharity– Baci Foundation– MobileEducationUnitatGlenTaylorSchoolinAuckland
MyRegisteredCharity– Baci Foundation– MobileEducationUnitatGlenTaylorSchoolinAuckland
ImageHeadlineTellmewhattheimageisreferringto.
drsharadpaul.comOpeningoftheMobileEducationUnit– May2018– Baci Foundation drsharadpaul.com
ImageHeadlineTellmewhattheimageisreferringto.
drsharadpaul.comOpeningoftheEducationUnit– May2018– Baci Foundation drsharadpaul.com
Conservation
Sustainability
MyRegisteredCharity– Baci Foundation– MobileEducationUnitatGlenTaylorSchoolinAuckland
MySkinSurgeryClinicinAuckland,NewZealand
MyRegisteredCharity– Baci Foundation– MobileEducationUnitatGlenTaylorSchoolinAuckland
MySkinSurgeryClinicinAuckland,NewZealand
drsharadpaul.com
SympathyScience
Sustainability
“Justaslawdoesn’ttranslateinto
justice,medicineisn’thealthunlesseachofustakespersonal
responsibility”
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