Evidence-based medicine is the application of a rigorous scientific standard in the practice of a medical profession. Physicians and other healthcare providers rely upon its tools and recommendations regularly. Yet, might there have been a time, although historically ancient, and even in today’s reality when the clinical application(s) of the art and even the sociology of medicine is utilized as much, or if not more than the usual gold standard? Such as, when a healthcare practitioner utilizes his or her gestalt and seeks to understand how the relevant aspects in a patient’s immediate environment and society at large affect the natural history or course of the disease and potential treatment outcomes. Does not that require a sympathetic point of view that may lead to the physician and patient being viewed concretely, but also abstractly as physician(patient) and patient(physician)? Patients are the best historians in terms of relaying the details of their home environment that a sleuth physician might hone in on and determine are causative factors that may have resulted in a clinical presentation.
The physician, now viewed and trained as the physician(patient) might be an even more reliable, and scientifically astute healthcare provider. When patients and physicians are viewed as mutually non-inferior then will this lead to improved healthcare outcomes? Is this a sympathetic approach to direct patient care? A priori healthcare services may not be the gold standard, however, there was a time when empirical knowledge and training were the expected course. And, perhaps there were still notable primary care outcomes, and fewer lawsuits on record. Although sociology and its scientific method, “the sociological imagination,” or “attitude of wonder,” may not be considered to be a rigorous clinical procedure. Is it not already regularly utilized through the clinical gestalt and through the application of concepts like “The Grandmother Principle,” and “Wisconsin Star Method?” And acquired through experience.
Therefore, with training focused on scientific application(s) of medical sociology a healthcare provider might conceivably be equivalent to, or better than one who is not. And the sought-after clinical endpoints, such as reduced mortality, morbidity, and the cost of care may be still acquired more proficiently and safely by the consideration of healthcare delivery. In addition, enhanced communication with the patient builds rapport and improves the doctor-patient relationship which may result in fewer lawsuits and increased patient and provider satisfaction.
The diagnostic imperative can be made following a thorough doctor-patient clinical conversation; and in the absence of a physical examination or the analysis of clinical chemistries. Would it benefit patients, at any point in time, to design an experimental medical school that focuses and trains future physicians thoroughly in medical sociology and the science of healthcare delivery and communication and less focus on the current educational approach? This might lead to a new gold standard that strives to understand the biopsychosocial model and the sociobiopsycho and how they impact the patient. A balanced medical education in both clinical colosseums is imperative, especially when we consider vulnerable groups like minorities, women, children, and other systematically oppressed healthcare cohorts.
Samuel K. Williams, III, MD, CPG is a Doctor of Medicine(MD) and Credentialed Professional Gerontologist affiliated with the division of Internal Medicine at Philadelphia College of Osteopathic Medicine-Suwanee Campus.