That mentality is terrible for everyone and every thing, except the physicians' careers.
I don't know if we need to select for better people when admitting them to medical school or if the culture is just completely fucked.
That mentality is terrible for everyone and every thing, except the physicians' careers.
I don't know if we need to select for better people when admitting them to medical school or if the culture is just completely fucked.
You already devoted probably half your life to becoming a surgeon, why would you screw it up and lose so much ground so easily?
From my own struggles of trying to find healing for chronic pain I have, I have realized that doctors/professionals are selected for for their memorization and not for critical thinking skills.
It's like doctor's stop thinking after they get their degree.
Whenever I've visited a doc within the past few years I have noticed that instead of actually getting to know someone as a patient, many act as if they are a quick reference book.
This is especially horrifying when you consider that there is a non-trivial portion of the population that exist outside of the medical literature.
Every one of the best Doctors I've ever had has ALWAYS been a researcher at heart. They observe, take notes, treat what they can now, and come back later and can clue me in on the latest research they've come across.
Nowadays, I'm usually making Doctors aware of advancements in their field... Scary stuff.
Are you taking about your cases? Because keeping on top of the narrow score that's currently relevant to you is a different level of time investment than keeping on top of everything happening in the field, after already learning a large part of it, and keeping in mind current treating guidelines which lag behind research.
I admit, things become a lot simpler once you limit your scope to issues immediately relevant to you as a patient.
However, I do still believe that when made aware of something new from a patient, a good physician should actively tackle the topic if only to be able to give a realistic assessment of where it falls on the risk/outcome spectrum.
NOTE: This may be assuming an above average level of patient investment. I in no way condone of wasting a physician's time having them wade through quackery. Nobody has time for that.
I don't find that to be too surprising. I can be hyper-aware of my own ailments, but keeping up with an entire field is more difficult. Furthermore, treating to research runs the risk of using treatments where the outcomes haven't been replicated, or there are long-term complications. Unless you've exhausted more conventional treatments/the treatment guidelines, there's something of an advantage of not being right at the bleeding edge.
I do not find the above to be sufficient justification to practice in ANY field without trying to stay aware of the state-of-the-art.
Yes, in medicine in particular, there is a justifiable bias toward applying more conservative treatments first. "Hear hoof beats, think horse first, not Zebra," is the axiom I believe is most frequently ground into new physicians.
The problem comes in when a physician becomes so conditioned to conservative treatments working that they become blind to the extremes. Running with the Zebra analogy, just because you hear hoof beats, you see a horse-like silhouette, and in this lighting you can't tell the color, does not mean you should IGNORE the possibility of Zebra.
As a practicing physician, you are DEPENDED upon to be the layman's gateway to the entirety of the collective medical knowledge base we've been able to accrue, verify, and are in the process of verifying. You owe it to your patients, just as an Engineer owes it to the public, to become as well acquainted with the medical literature as it pertains to them as possible.
I may be being a bit normative here, but an M.D. should be seen as a commitment to spending your life on the pursuit of the means by which to provide the highest quality of care for your body of patients. That at times means being ready to help the a patient access and navigate the less charted waters of the state-of-the-art if necessary.
I agree completely that state-of-the-art should not be the first hammer pulled from the toolbox, but one should not actively avoid it either. At the end of the day, data doesn't get generated out of thin air, and if the patient understands and accepts the risks after you have provided them the best guidance you can, you have done all that can be expected of you, have you not?
It's not a justification of not _trying_ to stay aware of the state of the art, but you always (potentially) stay ahead if you are focused on a smaller sub-field. I doubt it's possible to be completely aware of every single advancement for every condition you might encounter as it happens, nor is it suggesting that you should ignore the chance of zebra - for me, the best doctors have been those who will say "_I_ don't know; I will consult others or the literature", recognising that it's not possible for a single doctor to have exhaustive knowledge.
As with anything in modern society, bean counters rule and usually drive awful decision making.