Medical practitioners have been respected for thousands of years, even when their medicines have been toxic. To a large degree (and this includes both conventional and non-conventional medicine), this success can be attributed to the spontaneous cure and the placebo effect. Most medical conditions improve by themselves; and the placebo effect can be significant; thus, the patient attributes improvement to the practitioner. Until the movement toward evidence-based medicine in the early to mid 20th century, there was great uncertainty as whether a claim for a treatment’s effectiveness was due to the intrinsic potency of the medicine or to the placebo effect and spontaneous cure. This uncertainty still exists, but to a lesser extent, due to the introduction of properly designed research.
"Take two aspirin and call me in the evening."
The placebo effect, apart from the medication itself, also includes the bedside manner of the practitioner. The patient has confidence in the practitioner who spends time getting to know the patient, expresses concern about the patient, allays the patient’s fears, provides hope, and engages in laying on of the hands. Such bedside manner, or “grooming,” is an important part of medical practice, regardless of whether treatment is conventional or not. I learned this through 14 years of practicing Family Medicine with Lynn Carmichael, whom many consider to be the father of Family Medicine, having established the first Family Medicine residency in the U.S. and who was a strong advocate of grooming. Patients often go to an alternative practitioner rather than the conventional practitioner when the conventional doctor does not have the time to spend with the patient, a problem becoming increasing more common with the need to see more patients in a day. This problem will grow with future changes in the medical care system that may overwhelm doctors with more patients seeking care, with less time for grooming. Alternative practitioners often develop great skill in grooming the patient. It is important for conventional physicians to do the same.
The Goldberg Files
The Goldberg Files is based on the struggles of Dr. Goldberg as well as those of his many students which he observed while teaching medical school for 25 years. This extensive blog is dedicated to assisting students in dealing with the stresses of medical education. Want to learn more?