Exhibit A. Medical students report rates of depression up to 30% higher than the general population. About 400 U.S. physicians commit suicide annually, with the rate for female physicians four times higher than among other female professionals. A 2015 survey reported that 13% of male physicians and 22% of female physicians suffered from alcohol abuse or dependence. A 2021 study found that 63% of U.S. physicians experienced burnout, with one in five intending to leave their practice within two years. These statistics attest to medicine’s core problem that affects the welfare of patients and the health, sanity, and professional longevity of physicians. It is this: we physicians have traded in our former gods for ersatz idols.
Most modern doctors are not Osler’s healers of people but normalizers of data. Physicians comb computer printouts of molecular titers for hieratic meaning. Internists may order such tests before they even see a patient. However, only whole human beings reveal ultimate clinical truths. In atomizing patients into their tiniest components, MDs disconnect from patients and themselves. If docs spent more than five minutes per appointment and peppered their interviews with interest and caring, those pesky lumps of flesh on the exam table could sprout into actual people. What patients can reveal if given a chance would surprise clinicians and obviate hundreds of tests. Unless doctors start treating whole people, AI will displace them, and no one will know the difference.
To estrange themselves further from their calling, doctors bow as never before to the state and the corporation. They grovel before the altar of the “electronic health record,” or EHR, a corporate creation that widgetizes and dehumanizes doctor and patient. In 2016, MDs spent almost 40% of their patient care time (now surely higher) pecking on computers. No wonder they retire or leap from ledges.
Political ideology increasingly corrupts medicine. Quotes from three versions of the Hippocratic Oath illustrate the trend. The first of these is from the classic Hippocratic Oath, formulated in ancient Greece. “I swear by Apollo the physician…and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath…. With regard to healing the sick…I will take care that they suffer no hurt or damage…. Nor shall any man’s entreaty prevail upon me to administer poison to anyone [italics mine].”
Next the revised Hippocratic Oath, composed in 1964 by Louis Lasagna. In this version, God and gods have disappeared except for “I must not play at God.” There is no longer a do-no-harm clause. It refers only to “avoiding those twin traps of overtreatment and therapeutic nihilism.” This admonition is a tautology, for it is axiomatic that in any endeavor it is desirable, by definition, to avoid doing too much of it or too little.
Doctors, in order to save yourselves, you must decentralize your work away from large groups with their soul-sucking cultures and toward small, intimate groups and solo practices. True, you will earn less—perhaps a lot less—and in the process you will need to decide your purpose in life, why you are here. Stop being Big Pharma’s bitches, and learn about natural treatments. Be healers, not ideologues. Develop parallel systems of medical training and care that emphasize prevention and the treatment of the whole person. Not only do we need to save lives. We need to save our profession and our souls.