Before 1910, anyone with minimal education could “practice medicine”; quackery was rampant. The American Medical Association addressed this situation in 1908, commissioning Abraham Flexner to evaluate the poor standard of medical training and make recommendations for improvement. His findings were published as the “Flexner Report.” The AMA implemented them as the new standard for medical education to be based upon: “Theoretical scientific knowledge in a context-free and value-neutral terms as the primary basis for medical knowledge.”
The result of this change is the potent reductionist medical model whose curative miracles we daily enjoy. But at a cost.
Medical schools produce skilled technicians proficient in treating disease, but deficient in addressing the emotional impacts of illness on patients and families. When disease is the exclusive focus of care and nothing more can be offered the terminally ill patient, physicians may experience a sense of failure, and end-of-life patients can become unwelcome sights in the office. Flexner himself lamented this situation and, in 1925, wrote, “Scientific medicine is today deficient in cultural and philosophic background.”
During my 20-year practice as a urologist in Durango, a personal event opened my eyes to my lack of personal involvement with my patients. Consequently, I developed a genuine interest in their lives. I started a support group for “People with Life-Altering Illness.” Today, medicine is controlled by for-profit corporations. Physicians are constrained by time and productivity demands. Do we need a new Flexner Report?
Harry Kiracofe
Durango
