Monday, May 4, 2020

Book Review: 'The Little Book of Doctors' Rules: A Practical Guide to the Art of Healing' by Clifton K. Meador, MD

The Little Book of Doctors' Rules by Clifton K Meader MD

Bedside manner, compassion, and professional honesty

Tennessee author/physician Clifton A Meador earned his degree from Vanderbilt University School of Medicine and has served as both professor and dean of UAB (University of Alabama Birmingham) School of Medicine, as chief of medicine and chief medical officer for Saint Thomas Hospital in Nashville, and as executive director of Meharry-Vanderbilt Alliance. He has penned many books –medically oriented advice guides to nurses and physicians, medical detective stories including his brilliant FASCINOMAS – and now he crowns his output with this nonpareil testimony to restoring the Art of medicine.

Setting the tone for his impressive contribution to all physicians, both those in training and in practice, Meador states, ‘From my experience in primary care, and from discussions with colleagues, I have found that over 50 percent of primary care patients do not have a definable disease. They have complaints or symptoms but no medical disease. Nevertheless, while there may not be a definable medical disease to explain every symptom, every symptom has a definable cause. Uncovering these hidden causes takes careful listening, observation, and a collaborative, trusting relationship between professional and patient. Identifying these hidden causes is the essential role of primary care and a major focus of the rules in this book.’ 

In this new age of ‘medical advancement and technology,’ especially with the advent of EMR (electronic medical records), robotic computerize surgery, intervention of genetic modification etc that distance meaningful contact/communication between doctor and patient, much of the ‘art’ of medicine has disappeared. In this sensitive, wise book Meador offers rules to follow that may transform today’s jeopardize medical distancing into a return to compassion, caring, and healing.

The rules are categorized into Developing patient rapport (‘While listening to a patient, do not do anything else. Just listen.’), the Diagnostic process (‘Masses are either palpable or they are not. There is no such thing as a suggestion of a mass.’), Mental status examination (‘There is no blood or urine test to measure mental function and there may never be.’), Use of medication (‘If a drug is not working, cease its use.’), Caring for difficult patients (‘Some diseases are idiosyncratic to a patient.’), and Being a professional (‘All disease labels are abstractions. Only a patient is concrete.’).

There are 365 such rules that fill the pages of this sage physician’s book – a volume that should be required reading for all physicians and a library fixture in medical schools. Dr. Meador provides a light for these sullied medical care times. Very highly recommended. 

Editor's note: This review has been published with the permission of Grady Harp. Like what you read? Subscribe to the SFRB's free daily email notice so you can be up-to-date on our latest articles. Scroll up this page to the sign-up field on your right.