By HANS DUVEFELT
The art of medicine is such a common expression because, for many centuries, medicine was not a cookie-cutter business. It is a personalized profession, based on the science of the day, practiced by individual clinicians for various patients, one at a time.
Unlike industrial mass production, where everything from raw materials to tools to manufacturing processes is standardized and even automated or executed by robots, physicians work with raw materials of age, shape and form. different quality in what looks more like the restoration of damaged paintings or old automobiles.
The art of medicine is how and with what tools to take something damaged or faulty and make it better. There are general principles, but each case is different at least to some extent. In many cases, there are different ways to improve something that is malfunctioning, but patients may prefer to solve certain aspects of a complex problem because of their individual needs.
Restoring a very old car can be a different process depending on its intended use, such as parading it at auto shows or driving across the country. The wishes and expectations of patients can vary just as much.
The view on the optimal treatment of high blood pressure has become an automation vision as many have proposed letting pharmacists follow protocols, prescribing and dispensing drugs for better control.
But patients generally do not fit into such manufacturing paradigms. Some hypertensive patients also have swollen legs, a fast heartbeat, or spikes in blood pressure when they feel stressed. Some have naturally low potassium levels or cold feet in the winter. Careful, individualized choice of hypertension medication can make everyone feel and function better, taking more than one thing at a time. To know intimately all of the available drugs is infinitely more valuable to the patient than blindly following today’s treatment algorithm, as we have seen them all come and go.
To paraphrase Hippocrates: The life of algorithms is short, the Art of practice is long.
Hans Duvefelt is a rural family physician born in Sweden in Maine. This article originally appeared on his blog, A Country Doctor Writes, here.