“What is Jerusalem? Your holy places lie over the Jewish temple that the Romans pulled down. The Muslim places of worship lie over yours. Which is more holy? The wall? The Mosque? The Sepulchre? Who has claim? No one has claim. All have claim“
-Balian of Ibelin in the movie Kingdom of Heaven
Two separate incidents today got me thinking about what, exactly, is the practice of medicine. The first was this thread from the JEMS Connect forum about why people get into EMS. The second was a practical instructional session using standardized patients where one of the cases dealt with cultural conflicts (e.g. strict Muslim family with a male physician needing to draw blood from the wife, or a Christian Scientist family refusing care, including lumbar puncture, for their son who might have meningitis). My case was a man who went to a long term family friend for advice because he didn’t like the side effects of his bipolar medication. I was complimented for basically not reacting negatively about the fact that he sought care from a “witch doctor” (his words, not mine).
Both of those incidents got me to thinking about what, exactly, is the practice of medicine? At it’s most basic level it’s about finding a problem, fixing the problem, making the patient feel better (bonus points for both fixing the problem and making the patient feel better), and prevention. It’s all about gathering information (a history and physical), determining what is wrong (diagnosis), and giving recommendations (treatment plan and preventative care). However, don’t we all do this?
If I develop a problem and seek an over the counter solution, did I just practice medicine on my self?
If a friend recommends to you an over the counter medicine because it worked for her when she had similar signs and symptoms, isn’t that practicing medicine?
If a mother notices a diaper rash on her baby and changes her diaper changing routine and seeks over the counter medication, isn’t that practicing medicine?
Don’t all of those scenarios involve an assessment, diagnosis, and treatment plan, regardless of how basic it is? Outside of the breath and depth of a physician’s education, assessment, and available treatment options is there anything really different between a physician’s practice of medicine and, well, anyone else? Even witch doctors, faith healers, and traditional healers practice medicine in their own way, even if I personally, disagree with and disbelieve their methods. After all, isn’t the important thing that the patient is healed and feels better (not necessarily in that order) than where the cure comes from? As such, shouldn’t these people be allies for the patient’s health, provided everyone knows their limits.
While specific terms like “physician” should be, and are, protected, who can have sole claim to the practice medicine? No one has claim. All have claim.