The Most Impactful Teaching in Medicine: The Craft of “Unmedicine”
In the dynamic sphere of medicine, where intervention frequently takes precedence, a more subdued yet insightful ideology is gaining recognition. This is the craft of “unmedicine”—a persuasive concept suggesting that optimal care sometimes involves doing less instead of more.
Upon entering medical school, I imagined a profession filled with assertive actions. Yet, my clinical encounters have revealed a more complex reality. I’ve observed the significant effect of a physician dedicating an entire appointment to artfully guiding a patient away from an unneeded MRI. This was not simply inaction; it represented a refined type of action that fostered trust and eased patient anxieties.
This philosophy significantly pertains to the arena of de-prescribing. For older patients burdened by a plethora of medications, the decision to discontinue a pill can be an act of compassion. It fundamentally means reducing side effects and simplifying the intricacies of treatment, prioritizing quality of life. Such choices require a profound partnership with patients and a mutual bravery to pursue a different route. Nevertheless, this journey is fraught with obstacles—concerns about malpractice, satisfaction measures, and financial structures that favor quantity over quality.
As I aspire to be a future physician, I recognize that my training must include the equilibrium of these elements. It’s vital to comprehend not just how to treat but when to withhold treatment, cultivating the ability for vigilant observation. The future of healthcare necessitates doctors who regard well-timed pauses as among their most effective instruments. While adhering to evidence-based practices, it’s essential to respect the personal aspirations of patients, demanding ethical clarity and robust human connections.
Our generation is entering a system burdened by the repercussions of excessive care. We must become adept stewards of sustainable approaches, proficient in aligning clinical insights with patient values. The bravery to opt for restraint often surpasses the drive to act. I aspire to be a physician who recognizes that clinical excellence occasionally requires the removal of interventions instead of their addition.
The white coat symbolizes knowledge and action; however, I now believe it should equally signify the wisdom of understanding when action equates to restraint. This is the nuanced art of unmedicine, potentially the highest caliber of care we, as emerging physicians, can provide.
Kelly Dórea França is a medical student.