My Vision:

 

I believe that  a good medical practice should be based on a profound understanding of the patient as a whole.


The patient is a complex and dynamic system, prone to change, improvement and deterioration and his clinical picture is more  like a movie than a snapshot. Close observation of the dynamic aspects of the  disease course and the way the human body reacts to it is essential in understanding the  efficacy of implementing a certain treatment at a certain point in time.

Time is a factor that has to be  aknowledged as  a catalyst or facilitator of the healing process. Time as a reality of the doctor patient relation has to be understood in terms of  a  mandatory requirement. Doctors have to spend more time with their patients and patients have to understand that time is a vital component of the therapy. Most of the current available treatments do not offer an instant cure.


Medicine is not magic. Patience is a virtue of both  a good physician and a good patient. Our postmodern society is dominated by speed. Speed is  equivalent to efficiency in our system. Unfortunately, in medicine speed is very often detrimental leading to  quick changes in therapy, alternating medications,  switching care between different doctors, overdosing, polypharmacy. Rush  leads to errors. Doctors cannot afford to make errors. I am convinced that  educating patients about the importance of time in the  context of a succesful therapy will lead to improved outcomes and increased patient satisfaction.

Time can be used for the benefit of the sick people. Working with the patient as a team will help  the patient feel the impact of time in the healing process.A prescribing cascade is not the solution to the problems, but rather individualizing therapy and finding the one and only effective medication or therapeutic intervention. Taking more medication is not  what a patient needs, but taking the right one at the right time.


Throughout the years I have been puzzled by the fact that most medical text books do not comment on the duration of illness, the time to complete cure or the exact duration of the treatment. The reason is that  medical text books are based on statistical data , not on the personal features of a specific patients. Textbooks , journal articles and studies  are based on  „ cases” and „populations” and do not offer specific guidance or recommendations for each patient. The difference between medicine  as a science and medicine as „art” lies exactly in the   gap between theory and medical practice, between  the study of a case and  caring for a real person. Bridging the information realm with the „praxis” is the great challenge.


Besides time, I believe in clinical experience as the most important  factor in medical decision making.Experience is a result of time spent with patients  correlating direct observation with current medical knowledge and constantly refining and modulating different aspects of  practice based on  a better understanding of the patient as a person, as a complex and interactive open system and as a bio-psycho-social and spiritual  entity.


CRISTIAN HARGHEL, M.D.