2006-09-05 15:49:20 · 7 answers · asked by vikram b 2 in Science & Mathematics ➔ Medicine
It means doctors aren't as smart as they tell you they are.
2006-09-05 15:54:43 · answer #1 · answered by Helmut 7 · 0⤊ 1⤋
1
2016-05-28 22:11:35 · answer #2 · answered by ? 3 · 0⤊ 0⤋
You cannot diagnose or give a prognosis with 100% certainty; there is always the exception...knowing what could happen and having several contingencies to address it is what makes the physician artful. In other words, there are no silver bullets or cookie cutter solutions in medicine. The clinician needs to understand enough about the body and what works to be able to determine among several solutions, which is the one that might be the most effective...at least that is my take on it.
2006-09-08 20:34:24 · answer #3 · answered by ValleyViolet 6 · 0⤊ 0⤋
Osler was a great physician and he was also known as a great medical philosopher. The paradox or dilemma of this statement is characteristic of his joining these two disciplines to improve the practice of medicine.
I believe the quote means that scientifically it is possible to know exactly what is causing the patient's disease. But to know this the patient would have to be dead so that an autopsy could reveal the complete anatomic diagnosis.
In other words, you cannot know exactly what the disease was therefore you must use your reasoning ability and the available bits of evidence you have gathered to decide what the diagnosis probably is. The knack of deciding is an art.
One must use statistical probability help decide from among the clinical findings what the diagnosis is and is not and this will guide the art of treatment. One must also be able to adjust that treatment if it seems to prove the diagnosis may not be correct.
Osler brought the application of scientific methodology to the practice of medicine in the beginning of an astronomical rise in new scientific discoveries in chemistry, microbiology, virology, microscopy, pathology, radiology and other new disciplines which evolved after the turn of the 20th Century.
He performed medical experiments with cooperating patients that established the value of in vitro laboratory tests that were used to reduce uncertainty and increase probability of diagnosis without completely removing the art of medical practice.
Osler studied abroad under Rudolf Virchow, one of the father's of the scientific practice of Anatomic Pathology who applied new disciplines such as cell biology, immunology, microbiology to the understanding of pathogenesis of disease.
Osler autopsied patients who succumbed to their diseases in order to check on whether his diagnoses were correct and also to determine if there were anatomic and chemical correlates that might be helpful in making clinical diagnosis more accurate.
He directly studied the means of diagnosing Malaria by microscopically analysis of the blood. He identified different forms parasites in blood cells. He also went on to study the developmental cycles of malaria parasites within mosquitoes and the patient. The name of this disease, Malaria, made reference to the archaic belief that it was caused by foul smelling air (e.g. Mal = bad and aria = from the air) but Osler was able to show that patient's blood cells were parasitized by microscopic parasites.
This process of scientific exploration in medicine was justifiable because the alternative was to accept the opinion of doctors whose guess you most respected. Osler aimed to replace those guesses with data and observations so disease could be diagnosed scientifically.
He would be thrilled to see the use of computerized tomography, nuclear magnetic resonance imaging, polymerase chain reaction, and other methodology used as it is today to quickly and accurately diagnose diseases. Autopsies are still needed for final proof that the disease is what it was though it was but the accuracy of diagnoses today are where Osler wanted them to be.
2006-09-05 17:09:58 · answer #4 · answered by Art 3 · 1⤊ 0⤋
It's the same reason that doctors call their office a practice...nothing about medicine is concrete in itself. Since no, one treatment works for one person...doctors can only predict how a medicine will affect a person through previous precedents.
2006-09-05 15:56:56 · answer #5 · answered by Anonymous · 1⤊ 0⤋
One of the founders of Johns Hopkins Hospital - basically that medicine is nothing more than an educated guess which is successful most of the time.
2006-09-05 15:55:03 · answer #6 · answered by Anonymous · 0⤊ 1⤋
it means that doctors are smart enough to tell you that there is no certain way out of a problem.
it means that the practice of Medicine is not absolute... ever changing... dynamic...
it would be dull if it would be peg it to what we expect it to be.
2006-09-09 14:09:24 · answer #7 · answered by buji ph 1 · 0⤊ 0⤋