Doctoring

“People come to us for help. They come for health and strength.” With these simple words David Mendel begins Proper Doctoring, a book about what it means (and takes) to be a good doctor, and for that reason very much a book for patients as well as doctors—which is to say a book for everyone. In crisp, clear prose, he introduces readers to the craft of medicine and shows how to practice it. Discussing matters ranging from the most basic—how doctors should dress and how they should speak to patients—to the taking of medical histories, the etiquette of examinations, and the difficulties of diagnosis, Mendel moves on to consider how the doctor can best serve patients who suffer from prolonged illness or face death. Throughout he keeps in sight the fundamental moral fact that the relationship between doctor and patient is a human one before it is a professional one. As he writes with characteristic concision, “The trained and experienced doctor puts himself, or his nearest and dearest, in the patient’s position, and asks himself what he would do if he were advising himself or his family. No other advice is acceptable; no other is justifiable.” Proper Doctoring is a book that is admirably direct, as well as wise, witty, deeply humane, and, frankly, indispensable.

Few subjects hold more universal appeal than that of medicine, and surely few books have evoked medicine's drama and magic more powerfully than On Doctoring. In its many forms, from age-old ritual to the cutting edge of modern science, medicine concerns us all. It is a human profession, practiced by people who have dedicated their lives not only to science but also to humanity. In the words of the great physician-writer Sir William Osler, "The physician needs a clear head and a kind heart; his work is arduous and complex, requiring the exercise of the very highest faculties of the mind, while constantly appealing to the emotions and higher feelings." It is the humanity in medicine that has inspired the pens of countless writers, and that has now been captured in this remarkable anthology of medical literature. This newly expanded edition of On Doctoring is an extraordinary collection of stories, poems, and essays written by physicians and non-physicians alike -- works that eloquently record what it is like to be sick, to be cured, to lose, or to triumph. Drawing on the full spectrum of human emotions, the editors have included selections from such important and diverse writers as Anton Chekhov, W. H. Auden, William Carlos Williams, John Keats, John Donne, Robert Coles, Pablo Neruda, Ernest Hemingway, Raymond Carver, Alice Walker, Kurt Vonnegut, and Abraham Verghese. Among the new authors included in this edition are Rainer Maria Rilke, Lisel Mueller, and May Sarton. In this era of managed healthcare, when medicine is becoming more institutionalized and impersonal, this book recaptures the breadth and the wonder of the medical profession. Presenting the issues, concerns, and challenges facing doctors and patients alike, On Doctoring is at once illuminating and provocative, a compelling record of the human spirit.

Medical Wisdom and Doctoring aims to fill a need in the current medical literature for a resource that presents some of the classic wisdom of medicine, presented in a manner that can help today's physicians achieve their full potential. This book details the lessons every physician should have learned in medical school but often didn't, as well as classic insights and examples from current clinical literature, medical history, and anecdotes from the author's long and distinguished career in medicine. Medical Wisdom and Doctoring: the Art of 21st Century Practice presents lessons a physician may otherwise need to learn from experience or error, and is sure to become a must-have for medical students, residents and young practitioners.

This anthology of stories, poems, essays and quotations explores the duality of being both a woman and a physician.

American medicine attracts some of the brightest and most motivated people the country has to offer, and it boasts the most advanced medical technology in the world, a wondrous parade of machines and techniques such as PET scans, MRI, angioplasty, endoscopy, bypasses, organ transplants, and much more besides. And yet, writes Dr. Eric Cassell, what started out early in the century as the exciting conquest of disease, has evolved into an overly expensive, over technologized, uncaring medicine, poorly suited to the health care needs of a society marked by an aging population and a predominance of chronic diseases. In Doctoring: The Nature of Primary Care Medicine, Dr. Cassell shows convincingly how much better fitted advanced concepts of primary care medicine are to America's health care needs. He offers valuable insights into how primary care physicians can be better trained to meet the needs of their patients, both well and sick, and to keep these patients as the focus of their practice. Modern medical training arose at a time when medical science was in ascendancy, Cassell notes. Thus the ideals of science--objectivity, rationality--became the ideals of medicine, and disease--the target of most medical research--became the logical focus of medical practice. When clinicians treat a patient with pneumonia, they are apt to be thinking about pneumonia in general--which is how they learn about the disease--rather than this person's pneumonia. This objective, rational approach has its value, but when it dominates a physician's approach to medicine, it can create problems. For instance, treating chronic disease--such as rheumatoid arthritis, diabetes, stroke, emphysema, and congestive heart failure--is not simply a matter of medical knowledge, for it demands a great deal of effort by the patients themselves: they have to keep their doctor appointments, take their medication, do their exercises, stop smoking. The patient thus has a profound effect on the course of the disease, and so for a physician to succeed, he or she must also be familiar with the patient's motivations, values, concerns, and relationship with the doctor. Many doctors eventually figure out how to put the patient at the center of their practice, but they should learn to do this at the training level, not haphazardly over time. To that end, the training of primary care physicians must recognize a distinction between doctoring itself and the medical science on which it is based, and should try to produce doctors who rely on both their scientific and subjective assessments of their patients' overall needs. There must be a return to careful observational and physical examination skills and finely tuned history taking and communication skills. Cassell also advocates the need to teach the behavior of both sick and well persons, evaluation of data from clinical epidemiology, decision making skills, and preventive medicine, as well as actively teaching how to make technology the servant rather than the master, and offers practical tips for instruction both in the classroom and in practice. Most important, Doctoring argues convincingly that primary care medicine should become a central focus of America's health care system, not merely a cost-saving measure as envisioned by managed care organizations. Indeed, Cassell shows that the primary care physician can fulfill a unique role in the medical community, and a vital role in society in general. He shows that primary care medicine is not a retreat from scientific medicine, but the natural next step for medicine to take in the coming century.

Every doctor has the power to make a difference to the outcome for their patients by paying attention to how they practice the art of doctoring. How might we relieve the pressure on the healthcare system by engaging the most underutilised resource in healthcare design? The Art of Doctoring explores the answers to this question.

Towards the end of the twentieth century, the solution to mental illness seemed to be found. It lay in biological solutions, focusing on mental illness as a problem of the brain, to be managed or improved through drugs. We entered the 'Prozac Age' and believed we had moved on definitively from the time of frontal lobotomies to an age of good and successful mental healthcare. Biological psychiatry had triumphed. Except maybe it hadn't. Starting with surprising evidence from the World Health Organisation that suggests people recover better from mental illness in a developing country than in the first world, Doctoring the Mind asks the question: how good are our mental health services, really? Richard Bentall picks apart the science that underlies current psychiatric practice across the US and UK. Arguing passionately for a future of mental health treatment that focuses as much on patients as individuals as on the brain itself, this is a book set to redefine our understanding of the treatment of madness in the twenty-first century.

Addressing the problems facing medicine and medical education Cassell discusses the new generalism and the skills that physicians-in-training must be taught in order to practice the art of doctoring which centres on the person not the disease.