The drive to make medicine more productive has succeeded in making it more like the airline industry—just not in the way reformers intended. Instead, writes Montori, “impossibly busy appointment schedules and heavy patient loads force clinicians, even the kindest, to see patients as a blur.” Patients are almost as indistinguishable to their primary care doctors or hospital nurses as airline passengers are to the pilot who stands outside the cockpit after the flight has landed.
What is too often missing for both clinicians and patients is the human interaction that forms the ineffable “art” of medicine. On one side of the stethoscope stands a person in a white coat, name embroidered in cursive over her breast pocket. On the other side is a person in a state of a greater or lesser degree of vulnerability. The sicker we are as patients, the more we need to be acknowledged as individual persons, not just the passenger in seat 14B or the diner at table 12. We need our doctors to have the time to ask enough questions—and actually listen to the answers—in order to reach a correct diagnosis. We want to feel like a person who is cared about, rather than a mere vessel for a disease that requires treatment, or a bag of hormones and biochemicals that must be adjusted with drugs.
While reading it, I found myself thinking that the same can be said of the movement to turn education into a private enterprise focused on “workforce training.”