Medical education: creating physicians or medical technicians?

The 20th century witnessed phenomenal growth in scientific medical knowledge and technology, enabling physicians to more accurately diagnose and effectively treat a wide range of diseases. However, these advances led to longer and more complex training periods for physicians and increasing specialization and dependence on the new technology. An adverse outcome of these changes has been the development of many physicians who are less able to communicate with their patients and deal with them in a humanistic and personally caring manner; ie, the development of finely trained medical technologists as opposed to caring physicians. Their behavior and their blind trust in science and technology without understanding the patients in whom illness occurs often leads to making incorrect, incomplete, or inappropriate diagnoses or to unnecessary failures of treatment. It also results in excessive costs, hazardous procedures, and ill will from patients. Unfortunately, such technologically oriented physicians are often the primary role models for students. The best hope for a remedy to the problem lies in recognizing that it exists, understanding its causes, and modifying medical education accordingly. Providing students with good role models and some rudimentary techniques can lead to significant gains, but sophisticated programs have been designed only in some schools.