Letters to the editor
There is hope
I am writing in response to Dr. Evaleen Jones’ essay [“Artless
medicine: A physician’s view of a profession in crisis,” Winter 2005]. As a Stanford medical student, I can attest that the art of medicine and its transfer on to the next generation of physicians are not lost. There is hope.
I recognize the environment that Dr. Jones describes: I’ve seen and experienced what can happen to those giving and receiving medical treatment in an arrangement that seems to have very little care involved. “The system’s” regulations and restrictions, long hours, short patient visits and large piles of paperwork do indeed seem to derail the heart of medicine. In addition, medical education often seems to more obviously encourage the memorization of biochemical pathways and refinement of differential diagnoses than the appreciation of human interaction. However, as I’ve gone through my clinical training, I have seen the art of medicine vibrantly alive and well, even within the most constricting of circumstances. I have been taught by physicians within whom resides an element of healing that cannot be defeated by the system. I cannot help but learn from them.
While at Stanford, I have found kindred spirits and mentors in Dr. Jones’ family practice office, on the Stanford wards, in temporary shifts for one of the area’s largest HMOs, at a drug and alcohol rehabilitation center and in a small private practice. These people are superb diagnosticians. They are also able to connect and inspire. Whether it is through wisdom, profound patience, joie de vivre and enthusiasm, a deep sense of meaning and purpose, or some other unnamed intrinsic quality, they are the art of medicine. Their patients receive healing in ways that go far beyond the most advanced medical developments. They have provided me with an education that has helped me to grow into who I want to be as a physician and as a person. I look forward to continuing in this tradition and profession.
Kim Young,
Stanford medical student (fifth year)
Re: Michelle L. Brandt’s article, “Rush
to safety”
Problem: FDA approval of medications that later prove to be unsafe or dangerous.
Idea: Enlist public support to report all adverse effects via their pharmacist.
Pharmacists are professionals and are often key players on the health team. They could enclose a form with each prescription drug asking the patient to report any adverse effect incurred while taking the medication; there would also be a box to check if no harmful effects occurred. Refills would be dependent on returning this form to the pharmacist. No form, no refill — with exceptions, of course. The pharmacists could simply fax these forms to a central agency that would tabulate the results and keep the original on file for future reference.
Newton J. Harband, MD
Stanford ’66
I want to commend Ruthann Richter on her article for "America
the Pharmaceutical." While drugs are vital to the practice of
medicine, we physicians are too heavily influenced by the drug company
representatives and the favors they pass out (drug samples, sponsored dinners,
etc.). The medical profession should try to objectively evaluate cost and
efficacy in recommending and prescribing medications.
For example, Naphcon-A is an over-the-counter decongestant/antihistamine
eyedrop, quite effective in the treatment of allergic conjunctivitis.
A 15-ml bottle sells for about $11. When this product was no longer a
prescription item, the price fell. Alcon Laboratories, its manufacturer,
came out with an alternative, Patanol eyedrops. This prescription antihistamine
sells for about $105 for 5 ml, or 28 times as much as Naphcon-A! In my
experience, there is very little difference in clinical efficacy between
these two medicines. While some patients may eventually prefer Patanol,
I always recommend that they try Naphcon-A first, emphasizing the cost
difference and generally good results with the less expensive product.
Lee Shahinian, Jr., MD
Stanford ’71
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