The Patient: Biological, Psychological, and Social Dimensions of Medical Practice

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The old-fashioned doctor, whose departure from the modem medical scene is so greatly lamented, was amply aware of each patient’s personality, family, work, and way of life. Today, we often blame a doctor’s absence of that awareness on moral or ethical deficiency either in medical education or in the character of people who become physicians. An alternative explanation, however, is that doctors are just as moral, ethical, and concerned as ever before, but that a vast amount of additional new information has won the competition for attention. The data available to the old-fashioned doctor were a patient’s history, physical examination, and per sonal profile, together with a limited number of generally ineffectual therapeu tic agents. A doctor today deals with an enormous array of additional new information, which comes from X rays, biopsies, cytology, electrographic tracings, and the phantasmagoria of contemporary laboratory tests; and the doctor must also be aware of a list of therapeutic possibilities that are both far more effective and far more extensive than ever before.