The title's challenging question is only one of the many posed in
this wide-ranging examination of doctors and the practice of
medicine. Lantos, a physician who describes himself as a
professional moralist, is asking how recent developments in the
delivery of health care change "what we should think about the
proper response to illness and suffering, how we should train the
people whom we empower to respond, and how we should shape the
institutions that educate those people and deliver those services."
To explore these questions, Lantos, a bioethicist at the University
of Chicago and pediatrician in a hospital for chronically ill
children, tells troubling stories from his own experiences. The
role of doctors, says Lantos, has always been partly
interventionist (diagnosing and treating) and partly interpretive
(understanding and explaining the meaning of illness). The
interventionist model, he asserts, has won out. The essence of
modern medical practice is alienation, disengagement, and "a weird
equanimity in the face of horrific disease." Yet while we insist on
the physician as scientist, we still yearn in our hearts for the
old humanistic model of physician as shaman/healer. Lantos
questions whether a single profession can contain these
contradictory notions. We may, he says, be witnessing the creation
of a new profession "driven by science, technology, reductionist
ethics, and entitlement economics." He is not optimistic about the
future of medicine, questioning whether some core of morality or
belief will persist underneath the transformations that are taking
place. Fiction provides some of the most imaginative responses to
the question of what we want doctors to be and do, says Lantos, and
he concludes by turning to authors Robertson Davies and Walker
Percy, among others, for visions of the challenges facing doctors.
A disturbing, often painful examination of a profession in
transition. (Kirkus Reviews)
Does one need to be a doctor to deliver a baby, or to determine which types of lenses best correct myopic vision? Should only doctors perform physical examinations, or administer anesthesia, or determine when a patient should be discharged from the hospital? These provocative questions strike at the very heart of what it means to be a doctor. Do We Still Need Doctors? offers an incisive look at the doctor's shifting roles and responsibilities in our rapidly changing health care system. Exploring such issues as the structure of medical education, the corporatization of health care, and the increasing constraints upon the private doctor/patient relationship, John Lantos reveals how changes in our health care system are engendering new ways of understanding and responding to illness.
In addition to compelling firsthand accounts from his own medical practice, Lantos covers issues ranging from the growing emphasis on technology as healer and the physicians new role in the team-oriented health care system to the economic forces governing medicine and the limits of moral responsibility for patient care.
IDo We Still Need Doctors? probes the factors transforming the roles of doctors and health care institutions as well as our own understanding of health and healing.
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