The Art of Medicine




The health care system and its practitioners are under increasing pressure to provide efficient, effective, and consistent care to patients. Patients want to be treated as an individual, not a case number; insurance companies want to pay the least amount of money possible for services; and physicians, nurses, pharmacists and other practitioners want to provide the best care they can. Today, these constraints limit the ability of the health care provider to provide creative, innovative care and, instead, marginalize patients to an algorithm to treat their symptoms. Now, more than ever, fostering creativity may be the best way to improve the health care system.

The practice of medicine, and the rest of the health care disciplines, is deeply rooted in science. Rigorous medical education and training incorporates a didactic approach and an apprenticeship-type model of learning from experienced practitioners. Formerly, this approach resulted in practitioners who acted independently, with admittedly little consistency among those who practiced medicine. As patient populations and needs grew, the requirement for consistency and precision took priority, and now clinicians approach common problems in much the same way as one another. Obviously, the goal of all health care, and the education of its practitioners, is to provide the best possible care to each individual patient. But, a structured, scientific approach does not allow for individual differences.

More and more, the advantages of evidence-based medicine are promoted as a means of providing consistent care using the latest scientific data. Too often, this evidence is used as a rote tool applied to each patient, rather than a summary of available information that provides a guide for medical decision-making. The standardization and regulation required in today’s health care system has pushed creativity and innovation out the door, leaving room for endless paperwork and documentation.

Creativity involves the power to create and bring about change. Creativity involves originality, imagination, inspiration, and inventiveness. The visionaries and pioneers in medicine have always looked for innovative solutions to improve the practice of medicine. Fortunately, creativity is not restricted to great artists, but it can be fostered by training, encouragement, and practice. Creativity is a biological process, and people can be trained to be open to environmental stimuli than can provide opportunities for imagination and ingenuity. Everyone has the power to be creative; while not everyone will paint a masterpiece or write a great novel, everyone can be curious, seek change and take risks.

Medicine is an art. There is not always one right answer. Not every patient is cast from the same mold and broad brushstrokes of a one-size-fits-all treatment model are not always appropriate. Innovation and creative thinking is necessary to develop new methods of health care delivery, discover new medicines or treatment options, or prevent the emergence of new diseases. By educating health care practitioners to be more receptive to creative input and encouraging innovative thinking, the great minds entrusted with delivering health care will not become stifled by the repetition and unoriginality that is today’s health care system.

Many medical schools are catching on to the notion of medicine as a creative discipline and implementing classes and changing curriculums to cultivate novelty rather than penalize it. One notable program incorporates the structured teaching of fine arts concepts into its medical school coursework. This improves medical students’ visual inspection skills, thereby enhancing diagnostic ability and patient care. The students examine elements of art such as color and light, contour, form, texture and pattern, line and symmetry, and balance through works of master artists, including Paul Gauguin, John Singer Sargent, Pablo Picasso, Jackson Pollack, and Claude Monet, among many others.

Another innovative approach to medical education allows students to create art projects that express their reactions and thoughts about treating homebound chronically ill adults. An overwhelming majority of the students (97%) responded positively to the project and reportedly gained insights surrounding treating chronically ill patients that they may not otherwise have been able to articulate.

Medicine and health care should not be completely subjective. But, as with the more traditional concepts of “art” — music, painting, poetry, dance — medicine requires the objective elements of solid training and technique with an element of innovation and creativity. Whether dealing with an emotional patient or a challenging diagnosis, health care practitioners frequently need to think outside the proverbial box. Opportunities for creativity are endless: changing a patient’s behavior, applying a new treatment regimen, or listening to a patient’s story. By enhancing more traditional, artistic creativity, health care providers learn to be more reflective and introspective, allowing for innovative and original approaches to medical situations.

Medicine, while founded in science, has long been called an “art.” Likewise, the delivery of medical care is known as “practice,” though it will likely never be made perfect. The rigorous training and skills associated with providing expert medical care today leaves little room for individualization, but by fostering creativity among its practitioners, society will benefit from the innovation and ground-breaking discoveries realized by those entrusted to provide the best care possible.

References

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Fasnacht PH (2003). Creativity: a refinement of the concept for nursing practice. Journal of advanced nursing, 41 (2), 195-202 PMID: 12519279

Gauderer MW (2009). Creativity and the surgeon. Journal of pediatric surgery, 44 (1), 13-20 PMID: 19159713

LoFaso VM, Breckman R, Capello CF, Demopoulos B, & Adelman RD (2010). Combining the creative arts and the house call to teach medical students about chronic illness care. Journal of the American Geriatrics Society, 58 (2), 346-51 PMID: 20374408

Malterud K (2001). The art and science of clinical knowledge: evidence beyond measures and numbers. Lancet, 358 (9279), 397-400 PMID: 11502338

Naghshineh, S., Hafler, J., Miller, A., Blanco, M., Lipsitz, S., Dubroff, R., Khoshbin, S., & Katz, J. (2008). Formal Art Observation Training Improves Medical Students’ Visual Diagnostic Skills Journal of General Internal Medicine, 23 (7), 991-997 DOI: 10.1007/s11606-008-0667-0

Shaywitz, D., & Ausiello, D. (2004). Preserving Creativity in Medicine PLoS Medicine, 1 (3) DOI: 10.1371/journal.pmed.0010034

Jennifer Gibson, PharmD

Jennifer Gibson, PharmD, is a practicing clinical pharmacist and medical writer/editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. She is the owner of Excalibur Scientific, LLC.
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