What should our doctors be concentrating on?

by Ian W Halliday, February 1979

Doctor: one who cures those suffering from disease esp. by use of medicine.

So runs one dictionary definition - but is that what a doctor really is? Certainly a doctor must be expected to try to cure a person suffering from a disease or as a result of an accident, if a full return to health can be expected by the victim as a result of the treatment. Now, thankfully, the world has been rid of smallpox, or so it seems, and had almost been rid of tuberculosis as a result of modern science. But now we find that nine children in one school have TB. Fortunately, the disease can now be cured: the cure of children who have a long useful life in front of them is, I feel, far more important than the temporary relief of pain for the aged person who will probably only live a couple more years. Children are useful members of the society of the future and the aged have already ceased to be useful, and so are sponging off society more than they should be allowed to. Is this attitude fascist? Undoubtedly, and it is not one with which I hold. You do not make it clear where you abandon your support. RLJ What I am saying, however, is that the first priority of the doctors must be to cure those for whom full recovery is possible - and not the older members of society. there is no question at all in my mind that all invalids should be treated as much as is possible. There is a problem. Who finances the treatment? The taxpayer, perhaps? Or the victim?

On the question of prevention of illness, there is now little that can be done. If people did not drive on the road, there would be no road accidents. No smoking restrictions would lead to less deaths from lung cancer and associated diseases. But there is no way in which cigarettes, alcohol, car driving and the like could ever be banned. Inoculation is no longer needed for a great many diseases and for those where it is, parents are equally stubborn. "I couldn't possibly let little Jimmy have an anti-whooping-cough vaccination. I mean, I once read about somebody who got brain damage as a result. I'm not putting little Jimmy to any unnecessary danger." The danger of dying from the cough is 120 times the chance of even slight damage from the vaccine. The medical profession obviously needs to educate the population in a way which is near to impossible: near to the actual truth, rather than the sensational stories that every day shift so many million copies of the Mirror, Sun and Star.

What of research? Again, the typical man-in-the-street approach is not really helpful:
"I think research is necessary: how can you try new cures unless you test them? If they were successful you'd be able to cure thousands more people with it! And if it was a failure...(mumble, mumble)"
Interviewer: "Would you be prepared to act as a guinea-pig?"
"Yes, I would. But I couldn't possibly: I've got my family and kids to think of. I'd like to help, but sorry, no!"
Attitudes like that are again produced by the mass media.

The main time-wasting factor of the current situation is for such trivia as the doctor's note. The necessity for this document appears to lie in an intrinsic distrust of the human race. You claim you were unwell last week and unable to attend work. This you tell your boss, who won't believe you unless you have a signed note from your doctor saying you were ill. So you tell him. He doesn't care whether you were off ill or out playing golf so he signs a note saying you were ill. Result: bureaucracy that the medical profession could well do without.

Many people visit the doctor although there is nothing wrong with them. Twentieth century life is trying, even for twentieth century man or twentieth century woman. Sometimes they come to the doctor with a problem of worry, inability to sleep, stress, problems at work and a whole list of non-medical ailments. All these were dealt with in time past by such people as the priest and vicar, but now, in these times which are sadly lacking in Christian belief, it is the doctor to whom such problems are taken. Certainly he must concentrate on helping these people as much as he can - though, as he is unqualified in this field, they are unlikely to be cured by him. I still think that, as in the definition, doctors should be concentrating on healing people who, after the cure, can make a full and useful return to the life of the community.

(20) Most readable, but I think you are a bit unfair about the doctor's note. I believe that most doctors find it a worrying problem. Feb 13 1979. RLJ

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