Zen and the art of physician autonomy maintenance

Article Abstract:

The miracles of scientific medicine propelled physicians to an unparalleled level of clinical autonomy during the 20th century. During the past 20 years, physician autonomy has been declining, in part because the public has become aware that physicians are not consistently applying all of the science they know. One of medicine?s most cherished professional values, individual clinical autonomy, is an important cause of the sometimes suboptimal performance in the timely and consistent application of clinical science; thus, it contributes to the decline in overall professional autonomy. This paper calls for physicians to practice the science of medicine as a profession so that society will allow physicians to continue practicing the art of medicine as individual professionals. In a Zen-like paradox, physicians must give up autonomy in order to regain it.

Research and Development in the Physical, Engineering, and Life Sciences, Management dynamics, Medicine, Autonomy (Psychology), Author Abstract

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Evidence-based medicine gaining supporters

Article Abstract:

Some hospitals are integrating evidence-based medicine (EBM) into their residency training programs. EBM is a way of basing medical care decisions on evidence from controlled clinical trials. These trials are done to determine whether a particular treatment is effective. The Cochrane Collaboration reviews clinical trials and publishes the reviews on CD-ROM and on the Internet. The Agency for Health Care Policy and Research will provide funding to 12 medical centers that will apply EBM to specific clinical topics. Hand-held computers could deliver this information to physicians quickly.

Usage, Evidence-based medicine, Evidence, Scientific, Scientific evidence (Law)

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Understanding medical systems

Article Abstract:

Physicians should learn systems theory so they can take a leadership role in improving health care. A system is a set of interdependent elements that function as a whole. Examples include organizations such as a hospital and a medical practice, as well as processes such as treating diabetics. However, many doctors identify only with their own function, which leads to fragmented systems. The physician who learns about systems and how to manage them can make a significant contribution to quality health care. Eight principles of system theory are discussed.

Analysis, Systems theory

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