Life in Medicine: Becoming and Being a Doctor

Life in medicine: Becoming and being a doctor Name: Instructor: Institution: Date: Introduction Recognized as one of the most highly regarded and prestigious profession, medicine is not for the faint of heart. To be a physician, one must be accepted into a medical school and possess the grit it takes to withstand the challenging curriculum. But what does it take to succeed as a doctor? What makes a good doctor? Although there are thousands of answers to this question, curriculum changes over time, computerization of medical records, globalization of medicine culture, and establishment of regulating agencies have influenced physicians to adhere to high standards of healthcare practice. Despite Electronic Health Records (EHRs), having succeeded in enhancing accountability among physicians, simplifying their user interface allows doctors to interact more with patients rather than focusing on their computer screens. Similarly, reducing working hours, establishing physical activity programs, and encouraging doctors to speak in layman's terms enhance the delivery of healthcare while also improving the health of physicians. Some of the changes occurring within the healthcare industry have threatened the position of physicians. However, the continuous advancement in technology will enhance doctors' ability to tackle healthcare problems. Factors that have influenced physician to be "good" doctors * Curriculum changes Physicians can only be regarded as good doctors if they have the ability to collect medical, social, human, and spiritual information that contributes to the treatment of patients. Curriculum reforms implemented since the1900s have been significant in instilling data gathering and practical skills in physicians. During the civil war era, medical education in the United States was offered by for-profit proprietary schools, and content was mainly delivered in didactic form. However, in the early 1900s, the Flexner and Prichett report (1910) introduced a system where the emphasis on textbooks and lectures was replaced by clinical and laboratory teaching. This step moved medical education from a system that relies on memorization to a procedural system, using sound scientific information to treat patients. Between the two world wars, undergraduate medical education was further enhanced by dividing it into 2 phases; first preclinical studies are undertaken in the first two years while clinical rotation in various specialties is undertaken in the second two years. Among the changes introduced during curriculum development were Problem-Based Learning (PBL) in the 1970s and Evidence-Based Medicine (EBM) in 1981. Both PBL and EBM influence physicians to be good doctors by ensuring that their "selection of medical therapies relies less on institution anecdotal evidence and more on medical therapies that have been tested and determined to be effective in scientific research" (CH9, 207). Rather than just recognizing the core function of physicians to be the diagnosis and treatment of patients, curriculum reforms fit the physical process of performing these functions into the consultation and overall care of patients. Consequently, the analytical reasoning and methods used by physicians have been enhanced, thus turning them into good doctors. * Computerization of medical records With the advent of microcomputers in the late seventies and their subsequent performance enhancement in the eighties, computers have undoubtedly influenced physicians to become good doctors. In the mid 20th century, "doctors tended to act as independent agents, free from administrative oversight with little formal accountability" (McKinlay and Marceau, p 202). This behavior was influenced by the lack of proper records that showed who a physician had treated and the treatment plan that the patient was subjected to. However, since computerized information systems can capture clinical activities such as the length of stay of patients, physicians can easily review the medical records of patients and treat them accordingly. Importantly, after diagnosing and treating a patient, physicians must enter details regarding the diagnosis and treatment. In case a physician enters inaccurate data in the information system, he/she is likely to be summoned for malpractice or bad conduct. Therefore, the capability of computerized information systems to store huge medical records has influenced physicians to be good doctors by increasing their accountability to their profession and patients. Furthermore, computerized information systems have improved how physicians make decisions. The first incidence of using computers to improve decision making in medicine occurred in 1991 when the Institute of Medicine (IOM) published Computer-Based Patient Record: An Essential Technology for Health Care, a document that comprehensively examines the possibilities inherent in electronic medical records (EMRs). Currently, computers are widely used to analyze clinical data, enhance medical imaging, and conduct assisted therapy. Other specialized computer programs such as Computer Assisted Decision making (CMD) directly compliment doctor's natural abilities to make judgments regarding the care of critically ill patients. Through technology, physicians have become good doctors since they make decisions based on clear images and sufficient data. * Establishment of regulating agencies Regulating agencies such as the American Medical Association (AMA) have been significant in ensuring that doctors adhere to high standards of practice. During the early stages of the 18th century, physicians practiced medicine as part-time jobs. Since everybody could claim to be a doctor, some of the well-trained physicians were "troubled by the poor image of medicine and lack of standards in medical training and practice" (Conrad and Schneider p, 171). As a result, they established the American Medical Association (AMA) to promote the science and art of medicine and the betterment of public health. Today, the American Medical Association (AMA) has a government-granted monopoly on the healthcare system and restricts the number of doctors allowed to practice medicine. AMA's policies, including the code of conduct, have been significant in guiding how physicians interact with patients. These policies have resulted in well-trained doctors that focus on patients' preferences during diagnosis and treatment. * Globalization of medicine culture Globalization, which is both a social and political factor, has improved the skills and capabilities of physicians considerably. In the early 1900s, globalization was only related to the movement of tangible goods and the international financial system. However, since the 1940s, globalization has been continuously institutionalized in medicine, creating significant bodies such as the World Health Organization. Such international bodies establish certain rules that are universally accepted, thus influencing the conduct of all doctors regardless of their home country. For instance, NAFTA "provides for the free movement of physicians and other professionals between Mexico, the US, and Canada." (McKinlay and Marceau, p 201). This phenomenon ensures that physicians from the United States are well trained and have skills and capabilities that are acceptable in both Mexico and Canada. However, the globalization of medicine culture can foster divisions within local healthcare systems, especially in developing counties. Patients, for example, may prefer doctors who have been abroad despite lo...