By the Bedside of the Patient

Lessons for the Twenty-First-Century Physician

Nortin M. Hadler, M.D., Nortin M. Hadler M.D.

• Publisher: The University of North Carolina Press
• Year: 2016
• Print ISBN: 9781469684093, 9781469626666
• eBook ISBN: 9781469626673
• Topic: Medicine
• Subtopic: Health Care Delivery

In By the Bedside of the Patient, Nortin Hadler places current efforts to reform medical education — from the undergraduate level through residency programs and on to continuing medical education — in historical context. In doing so, he traces the evolution of medical school curricula, residency and fellowship programs, and the clinical practices they promoted. Hadler examines crucial junctures in history to locate the seeds for reform. Some believe that medical education and training should highlight literature, ethics, and culture, while others emphasize science and efficiency to abbreviate the time from entry to licensure. Neither of these approaches, Hadler argues, maintains or improves patient care, which should be at the core of medical education and practice. Hadler contends that most reform attempted thus far constitutes, at best, little more than a reshuffling of the basic curriculum and, at worst, an augmenting of medicine’s predilection to measure, grade, and record. Examining generational changes in medical education, Hadler mines sixty years of training and practice to identify mistaken approaches and best practices. Ultimately, in the contemporary era of managed care, Hadler argues for a clinical practice that draws on the best available scientific knowledge, transmits the wisdom of experienced clinicians, reforges an empathetic relationship between physician and patient, and treats each patient as an individual — all centered on restoring the mandate to care.

Table of contents

• Cover Page
• By the Bedside of the Patient
• Copyright Page
• Dedication
• Contents
• Figures
• Acknowledgments
• Introduction: The Echoing of Medical Humanism
• Chapter One: The Doctor, the Patient, and the Hospitals of the 1950s
• Chapter Two: Academics and Medicine in the 1960s
• Chapter Three: The Golden Age That Wasn’t
• Chapter Four: The Assault on Clinical Education
• Chapter Five: Sacrificing the Patient on the Altar of Industrialization
• Chapter Six: De Morte Medicinae
• Chapter Seven: Missing the Forest for the Granularity
• Chapter Eight: Where Have All the Physicians Gone?
• Chapter Nine: Medical Professionalism in the Twenty-First Century
• Enlightenment at the End of the Tunnel
• Notes
• About the Author
• Index