It may be difficult to believe a profession that commands the salary and social status of U.S. physicians is in crisis, but there is widespread and growing discontent within this guild. While serious reform is afoot for the health care system writ large, the clinicians at its center (or at its top) are receiving scant attention.
In The Finest Traditions of My Calling, Abraham Nussbaum offers a plea to see that true reform of the health care system will be possible only if we also seek a renewal of the physician's practice. With compelling narratives from his own experience as a psychiatrist, Nussbaum's entreaty is easy to believe.
The author's central argument rests on the premise that none of the innovations currently being discussed can truly transform medicine. We tinker at the edges with value-based payment reform, electronic health records and population health. We obsess over quality improvement measures and evidence-based practice. We invest in programs designed to bring the humanities back into education, to wed the art with the science of medical practice.
The author suggests, "The advances in knowledge in twentieth-century medicine began…when physicians began to see like scientists. And I suspect that medicine will advance once more only when physicians change their self-perception again." The sine qua non for us to realize medicine's future is this new vision—or, perhaps more correctly, it is an old vision, renewed.
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