The Retreat From Patients

Abstract

The currently prevalent retreat from patients has many roots: work with patients is painful; a general tendency to undervalue clinical skills; a general failure to realize how long it takes to acquire clinical maturity; the emphasis on research for tomorrow's medicine, at the expense of service for today's needs; propaganda for service to "the community" as though this did not require the highest degree of knowledge of individual human needs; higher academic rewards (rank, status, salaries) for everything but clinical skills; the tendency of top-rank full-time professors to set a bad example by their full-time absences. Consequently, although everything to which these fugitives from patients flee is good, the results of their flight are disastrous for American medicine. In no discipline is this trend as destructive or as prevalent as in psychiatry.