In How Medicine Works and When It Doesn't, F. Perry Wilson, MD, guides readers through the murky and often treacherous landscape of modern medicine.
, F. Perry Wilson, MD, guides readers through the murky and often treacherous landscape of modern medicine. The book could well have been titled. In Wilson’s view, Americans no longer trust their doctors the way they once did, and that lack of trust can have life-threatening consequences.
Doctors are often a bit trepidatious meeting a patient for the first time. By the time we open the door to the exam room, we’ve read through your chart, looked at your blood work, and made some mental notes of issues we want to address. Some of the more sophisticated practices even have a picture of you in the electronic medical record, so we have a sense of what you look like.
because I wasn’t confident in my diagnostic abilities – like all young doctors I hadn’t yet learned how much I didn’t know – but because I was worried that whatever thoughts I had about her possible ailment would not be enough. What could I offer that all these others couldn’t?Eleven seconds. That’s how long the typical doctor waits before interrupting a patient, according to a study in the Journal of General Internal Medicine.
And I felt ... Well, to be honest, I think the emotion I felt was jealousy. It would be one thing if no one could help poor Ms. Meyer, depressed and unwilling to even entertain the diagnosis, but someone did help her. Someone whose worldview was, in my mind, irrational at best and exploitative at worst. My instinct was to dismiss
It took me a long time to figure out why – fifteen years, actually. In that time, I finished my residency and fellowship at the University of Pennsylvania. I got a master’s degree in clinical epidemiology . I was brought onto It turns out the most powerful force in Medicine is not an antibiotic. It isn’t stem cell therapy, genetic engineering, or robotic surgery. The most powerful force in Medicine is trust. It is the trust that lives between a patient and a physician, and it goes both ways. I trust you to tell me the truth about how you feel and what you want. You trust me to give you the best advice I can possibly give.
While the healthcare system and physicians are not synonymous, physicians are the face of that system. In earlier times, we ran that system. It is no longer the case. Most physicians haven’t realized this yet, but we are no longer a managerial class. We are labor, plain and simple, working for others who, without medical training but with significant business acumen, use our labor to generate profit for companies and shareholders.
Anyone who tells you otherwise is selling something. This book will show you how to grapple with medical uncertainty and make rational decisions in the face of risk. true, whether or not you believe in it.” When it comes to the speed of light, the formation of nebulae, and the behavior of atoms, this is true. The laws of the universe are the laws of the universe; they “change” only insofar as our tools to study them have improved. But Medicine is not astrophysics. It is not an exact science. Or if it is, we have not yet explored enough of the nooks and crannies of the human machine to be able to fix it perfectly.
you want to make the best, most rational choices about your health. The answer you are looking for might not be the right answer. That’s why we will discuss, right in the first chapter, how before you know who else to trust, you have to learn to trust yourself. When you read this book, you’ll learn that doctors aren’t perfect. As humans, we have our own biases. Rigorous studies have shown
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