Showing papers in "Mens Sana Monographs in 2006"

Medicine: science or art?

Abstract: Debate over the status of medicine as an Art or Science continues. The aim of this paper is to discuss the meaning of Art and Science in terms of medicine, and to find out to what extent they have their roots in the field of medical practice. What is analysed is whether medicine is an "art based on science"; or, the "art of medicine" has lost its sheen (what with the rapid advancements of science in course of time, which has made present day medicine more sophisticated). What is also analysed is whether the "science of medicine" is a pure one, or merely applied science; or the element of science in it is full of uncertainty, simply because what is accepted as "scientific" today is discarded by medical practitioners tomorrow in the light of newer evidence. The paper also briefly touches upon how, in the field of present medical education, the introduction of medical humanities or humanistic education has the potential to swing the pendulum of medicine more towards the lost "art of medicine".The paper concludes by saying that the art and science of medicine are complementary. For successful practice, a doctor has to be an artist armed with basic scientific knowledge in medicine.

Where is medical practice in India heading

Abstract: Medical practice is based on teaching, learning and examples set by seniors. Past and present practices are briefly analysed. Current trends do not justify optimism. The poor patient is likely to be sidelined as doctors reach out to the rich and powerful in this country and those bringing in American dollars from abroad. While corrective steps are possible, it is unlikely that they will be implemented.

What does biostatistics mean to us.

Abstract: It is human nature to try to recognize patterns and to make sense of that which we observe. Unfortunately, our intuition is often wrong, and so there is a need to impose some objectivity on the methods by which observations are converted into knowledge. One definition of biostatistics could be precisely this, the rigorous and objective conversion of medical and/or biological observations into knowledge. Both consumers of biostatistical principles and biostatisticians themselves vary in the extent to which they recognize the need to continue the improvement. Some may not recognize the need for (some or all of) the methods that have already been developed; others may accept these as they find them completely sufficient; still others recognize both the value and the shortcomings of these methods, and seek to develop even better methods to ensure that future medical conclusions are less subject to biases than current ones are.

What medicine and medical journal editing mean to me.

Abstract: Medicine and medical journalism are both noble professions. Those who are infected with the materialistic virus and want to make quick money should not take up these as professional careers. Editing a good quality peer reviewed medical journal in a developing third world country is extremely frustrating. An editor has to work under considerable stress and strain, and face numerous pressures. However, it is a joy and pleasure to be a successful medical editor. The mere fact that one can help so many authors and influence decision makers in the medical profession, health officials, pharmaceutical trade and industry and all others connected with the health sector gives tremendous professional satisfaction, which is invaluable and keeps one motivated.

Medicine and money: friends or foe?

Abstract: The relationship between medicine and money is a delicate one that all people involved need to handle responsibly. If one becomes a physician for the mere fact of pursuing money, s/he may soon find that another profession or activity may have fulfilled such a need in a better way. While in the practice of medicine the interest of the patient is paramount, this does not suggest that the welfare of the physician should be neglected at all. It is much about a balance of priorities between the legal and ethical pursuit of money and the promotion of the health of society. Physicians are not called to a life of self-denial, poverty and destitution, as others may be tempted to suggest. The service of patients and the honest reward from one's labour are not incompatible. Where conflict of interest arises, it is prudent for a physician to always remember never to harm oneself, the profession and the patient more than what can be gained.

A look at CMAJ: A misty image indeed

Abstract: Full Text The date: Feb 20, 2006. Medical publishing was rocked by the sudden dismissal of the Editor In Chief of the CMAJ (Canadian Medical Association Journal), John Hoey, and a Senior Deputy Editor Anne Mary Todkill. The Editor appointed in the interim, Stephen Choe and another Deputy Editor Sally Murray, also resigned in a week's time, on 28 Feb to be precise. Along with them also went Jerome Kassirer, a former CMAJ editorial board member and a former editor of the New England Journal of Medicine (NEJM), appointed to frame regulations or governance plans about editorial independence. All these are well-respected professionals in the field of biomedical publication and there has been a huge outcry, both in the medical as well as popular press, at their abrupt sacking. If this were not enough, fifteen out of the nineteen members of the editorial board of the CAMJ also resigned, precipitating a grave crisis. In the meanwhile, the CMA, in an attempt at damage control, appointed an interim Editor, Noni Macdonald, along with an Editor Emeritus, Bruce Squires, who has been an earlier editor of CMAJ , and a founder member of WAME. A retired Chief Justice of the Canadian Supreme Court has been appointed to chalk out a Governance Plan for Editorial independence. Changes are also envisaged in the JOC (Journal Oversight Committee). The CMA President is exhorting everyone concerned to move on, and has assured a policy of editorial independence. The atmosphere, at the time of writing this, is combative and smoldering, and a distinct unease prevails.

What psychiatry means to us.

Abstract: Psychiatry has come up as one of the most dynamic branches of medicine in recent years. There are a lot of controversies regarding concepts, nosology, definitions and treatments in psychiatry, all of which are presently under a strict scanner. Differences are so many that even the meaning of psychiatry varies amongst individual psychiatrists. For us, it is an art to practice psychiatry and give the patient what he needs. Still, it should be practiced with great caution and utmost sincerity towards the patient, based on scientific knowledge and not to be guided by individual conceptions alone. Ethics in psychiatry forms an integral part of its basic concept and meaning, and a tight balance should be maintained between professional advancement and patient benefit. In recent years, the scope of psychiatry has enlarged considerably, with wide ranging influences from Sociology, Anthropology and Philosophy on the one hand, and Neurology and Medicine on the other.

What clinical pharmacology means to us

Abstract: Clinical Pharmacology is a specialty with many attributes and our association with the subject has allowed us to acquire, apply and disseminate myriad aspects of research and practice Though clinical pharmacologists are conspicuous by virtue of their small number, recent years have shown a growing need for the course In the review below we navigate through several aspects of the subject as we encountered them from time to time From critical appraisal of literature, to application of knowledge of drugs, to clinical practice; moving on to clinical and basic research, to drug development process, to policy making - these are but a few of the many fields which constitute the scope of clinical pharmacology The importance of the subject lies in allowing a trainee to develop a broad overview of the entire process, from drug generation to drug distribution to drug utilization, a process meant for the greater common goal of better health for all We foresee a bright future for the subject though with a slight skepticism thrown in In the present article, we make use of personal experiences and reference from literature to help you get a broad view of what clinical pharmacology means to us

What does addiction mean to me.

Abstract: Addiction is compulsive need for and use of a habit-forming substance. It is accepted as a mental illness in the diagnostic nomenclature and results in substantial health, social and economic problems. In the diagnostic nomenclature, addiction was originally included in the personality disorders along with other behaviours considered deviant. But it is now considered a clinical syndrome. Addiction is multifactorially determined, with substantial genetic influence. The development of addictions is also influenced by environmental factors, and an interplay between the two. In the clinical context, addiction puts problem substance use on the agenda, and helps focus on the difficulties associated with drug use. But the concept of addiction is also used to distance the user from addicts, and in this way, may be counter-therapeutic. The addiction concept has also had a substantial influence on policy. The almost universal prohibition against drugs such as opiates, cocaine, cannabis and amphetamine has much support. But unfortunately, it has not been able to hinder the development of substance use problems. Optimism is fostered by the development of respectful ways of thinking about people with addictions, in particular, from advocates of motivational interviewing.