Report - 8th November 2011

Dr Iona Heath: Tomorrow’s patients for tomorrow’s doctors

Dr Iona Heath, President of the Royal College of GPs, gave an inspirational and scholarly address to the Society. She started with the front cover of the GMC booklet ‘Tomorrow’s Doctors’ and highlighted its image - the ‘real man’ looking at his biomedical image reflected back to him. This epitomised the debate for her - ‘the way in which the doctor, uniquely, combines and objective knowledge of the biology of the body...with the subjective experience of living’. Tomorrow’s doctors will need to face the challenges of increasing medicalisation of human experience, in resource constrained environment of increasing costs of medical technology. They will need to learn to make decisions about what is inappropriate and ineffective, particularly in end of life decisions, and develop the optimal balance between curative and preventive healthcare.

Dr Heath spoke eloquently about our dawning understanding of the effects of stress on biological functions and how we can no longer compartmentalise the ‘psychological’ from the ‘biomedical’. However, as a profession, we still form these silos, with little effort to bridge the gaps. Tomorrow’s Doctors will need five dimensions of literacy: medical (the biomedical model we all espouse), physical (empathetic interpretation of the patients symptoms which lies at the root of diagnosis), emotional (the acknowledgement and witness of suffering and pain), cultural (understanding how others have made healing sense of suffering and pain)... and moral literacy. Moral literacy is the moral courage needed to make professional judgements in the face of uncertainty and changing knowledge and opinion. Dr Heath finished by commenting that thinking about the future may be a suspect activity because it allows us to neglect the present. She finished with a quote from Isaiah Berlin on a Russian thinker, Alexander Herzen: ‘he believed in reason, scientific methods, individual action, empirically discovered truths; but he tended to suspect that faith in general formulas, laws, prescription in human affairs was an attempt, sometimes catastrophic, always irrational, to escape from uncertainty and the unpredictable variety of life to the false security of our own symmetrical fantasies’. Remembering the ‘whole is more than the sum of the parts’, wisdom that is important to both patients and doctors.