It’s a question which has been asked time and time again: is medicine a science or an art? The practice of medicine is in a special position by lying quite strategically on the shared boundary of science and art. In this article, this statement will be further explored in the hope that it contributes to the many answers which have come before it.
Why does this question matter? Medicine is an applied science which deals with people in all its aspects. Due to this, it is highly unlikely medicine is purely a science or an art. With humans caring for other humans in this field, it is impossible to be completely objective as required in scientific fields. It cannot be a pure art, as doctors have to be knowledgeable about the science of diseases and their pathophysiology in order to treat patients effectively.
Science pervades every aspect of medicine; especially since the advent of evidence-based medicine. The pathophysiology of most diseases are well documented, thanks to careful scientific observations and documentation. Treatment of illnesses & injuries with drugs & surgical procedures are tested vigorously against existing methods and placebos in clinical trials. Clinical trials are carried out as scientific experiments, with: control groups; predetermined outcome measures; and the recognition of potential biases. In the clinical setting, doctors use the scientific method to diagnose patients by formulating hypotheses based on the patient’s history and symptom presentation. They then conduct investigations such as blood tests and imaging to verify their hypotheses. Finally, they form a conclusive diagnosis by considering the evidence obtained from their investigations. This allows doctors to have a systematic diagnostic approach. By eliminating red herrings and focusing on the matter at hand, the likelihood of an accurate diagnosis is higher. This is followed by the initiation of a suitable treatment for the patient. Science also plays an important role in the technology used in investigations and treatments.
The artistic element of medicine – in its subjective sense, rather than aesthetics – lies in the art of dealing with people. Humans are complicated beings, with emotions which should definitely be considered by doctors who are seeking to improve their health. Patients are not looking to be treated by someone who solely has a perfect knowledge of all the diseases in the world; they are looking for a doctor who will take the time to understand and address their concerns. Doctors should empathise with their patients by being aware of their social background, how their illness may affect their daily routine or potentially, even their source of income. Listening to patients, and fostering an open but confidential environment where they are able to share their feelings, may also contribute to the formulation of an accurate diagnosis. Doctors might even pick up some information which was not mentioned previously when taking their medical history. A culturally aware and competent doctor will win the hearts of their patients, who will then more likely be compliant with regards to prescriptions and health advice. This is especially true if the patient is a minority or is an individual new to the country or city. A doctor who treats them fairly, without a hint of discrimination, may be all they need to take control of their health in a positive manner. Patient autonomy is a cornerstone of medical ethics that should be upheld at all times. Doctors should ensure that patients have access to all the information they need to make the decision they feel is right. This could be looking for a pamphlet in a different language, requesting information in Braille or simply writing down the URL of a useful website. Essentially, what lies at the heart of the art of caring for fellow human beings is being a good human being yourself. Being compassionate towards patients who are undergoing a trying time of their lives, either due to their disease or personal circumstances, is something priceless which every patient will truly appreciate from their doctors.
It is clear that medicine is a distinctive blend of science and art. Both of these elements strike a precious balance which prospective medical students should be aware of. The art of medicine lies in the application of its science. As a doctor, there is no point in being able to deliver the correct diagnosis without having the ability to deliver it in an appropriate & sensitive manner, then follow it up with the right amount of emotional support. Equally, it is pointless to have a fantastic bedside manner but be incompetent when it comes to diagnosing and treating the patient. Medical education has been very science-based in recent decades, however the introduction of opportunities for medical students to improve their communication skills & cultural awareness will serve to add to the polishing of their bedside manner.