Looking for Simplicity in Medicine
A simple life has a different meaning and a different value for every person. For me, it means eliminating all but the essential, eschewing chaos for peace, and spending your time doing what’s important to you.
It means getting rid of many of the things you do so you can spend time with people you love and do the things you love. It means getting rid of the clutter so you are left with only that which gives you value.Leo Babauta, Zen Habits
One of my key values and dreams for 2009 is finding simplicity. This focus was unplanned, but has come about through reviewing 2008, and looking at the coming year. It is currently popular to think about living more simply, and people are beginning to see the value in slow food, close relationships and a focus on living the life.
I think this is also a key issue in medicine, and I want to try to address it in my life.
Medicine is complex
Medicine and the health professions are self-complexifying.
- Lots of information to assimilate
- A surplus of patients to see
- Less doctors than we would like
- Shifting goalposts
- The lack of medical fellowship
- More documentation
The state of the art is Evidence Based Medicine. And the Evidence is overwhelming. Each change in practice is normally supported by multiple trials, and meta-analyses. As individuals, we are expected to keep up, and filter out the irrelevant, without missing the paradigm-shifting results.
This means there is always pressure to fit someone else in, to not go home.
When there are less doctors than necessary, we need to turn people away if we want to slow down. There is no one else to mop up.
Best practice changes. We all know guidelines have changed, targets for hypertension, or cholesterol drop. Preventative medicine guidelines change. We need to keep up. It creates a sense of unfinished business to know this stuff can change without us realising.
Dealing with other professionals is a vital part of maintaing sanity, and even staying current. But this is the time we tend to sacrifice, if we feel under pressure. So fellowship gets mixed into “drug dinners” and other functions. In the end, we get our peer-support scheduled by local pharma reps, or crammed into breaks between patients
The need for documentation has increased with medico-legal pressure. The growth of multi-doctor practices also means that a doctor can’t keep their patient information in their head in fear of disadvantaging a colleague.
How to Make Achieve Simplicity in Medicine
According to Leo Babauta of Zen Habits, there are two steps to achieving simplicity:
- Identify that which is important to you
- Eliminate everything else
I am obviously not an expert on having a simple life, but I am going to use the next couple of posts on this blog to explore ways of achieving Simplicity in Medicine. I can only look at the field in which I work. Please contact me if you are willing to share your ideas for Simplicity in Medicine.
What do you think?
Do you think medicine is too complex? Is it inevitable? What makes it all so complicated? Leave your thoughts in the comments below.
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You’ve hit the nail on the head Cris.
A value-focused approach not only in medical practice but in life is a very worthwhile pursuit. Complexity in medical information and management puts clinicians at risk of relying on marketing for decision making. Brands are essentially cognitive shortcuts through excessive information and consideration of facts, but they often bypass evidence and plain common sense.
And why do we rely on industry for fellowship? Because its easy.
Every move closer towards a rational estimation of marginal benefit for each expensive and additional intervention and interaction we undertake is a vaccination against a move towards the USA’s pattern of grossly inefficient health care expendititure.