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First do no harm

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The most important aspects of health care in my 20 plus years of working in medicine goes like this –

PREVENTION

LOVING CARE

TREATING A PERSON AS A WHOLE BEING AND NOT JUST A SYMPTOM

In all health care professions there are caring people and the opposite. I hear about them all, good and bad, from experiences people have in trying to improve their health. Recently I read a report from a specialist to a GP concerning a patient. It was written in a kindly tone with a word choice that portrayed compassion. I was pleasantly surprised.

I recently spoke to someone who works for a GP who announced he had no interest at all in food and nutrition’s impact on health. I was left wondering what kind of medicine can they possibly be in. It was hard to understand how they could really believe that nutrition has no impact on health. Is it because medicine has become more like a business, that there is no interest because there are drugs to sell?

 

“There is no doubt that a “more medicine is better” culture lies at the heart of healthcare, exacerbated by financial incentives within the system to prescribe more drugs and carry out more procedures.”
Dr Aseem Malhotra

 

“It’s my job to figure out what a physician’s price is. For some it’s dinner at the finest restaurants, for others it’s enough convincing data to let them prescribe confidently and for others it’s my attention and friendship…but at the most basic level, everything is for sale and everything is an exchange.” —Shahram Ahari, drug rep.

 

 

The Hippocratic Oath is a useful reminder and should be pasted to every clinicians wall.

 

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.

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