Medicine as the last uncompressed profession
The difficult uncompressible work of medicine is unmeasurable. How might we measure “difficult diagnosis”?
What value do we place on the master diagnostician who can sort out many vague complaints into an unexpected diagnosis, when no one else can?
Sure, routine treatment of straightforward diabetes or asthma can be ‘compressed” into measurable process and goals, but “failure to thrive” or “fragile elderly with polypharmacy” or “internal medicine patient with 17 diagnoses who is falling more often” or “undifferentiated severe abdominal pain” doesn’t fit anywhere, can’t be measured, and its care cannot be made more efficient.
Are we training a generation of doctors who are excellent at compressed care? When our older generation of doctors retire, will patients with unmeasurable suffering no longer have someone to care for them?
In all the noise of “Value based care” and “Private Equity” and “squeezing the inefficiency out of the bloated US healthcare industry” where are the quiet ones, the hidden heroes out there caring for patients?
Yes, Generative AI is coming. Yes, EHR tools and “clinical decision support.” Yes, advances in team-based, multidisciplinary, highly coordinated care.
And yet.
Where are the ones championing the statement attributed to Hippocrates:
Cure sometimes, comfort often, care always.
