Would you Expect this to Be true of Medical Subspecialties too (See Below)?

Question

Years Ago I Saw a Cartoon Depicting Several Designs of a Simple Airplane Designed By Several Engineering Subspecialties, None Could Be Seen to Fly.

Answer 1

Brings to mind a couple of old stories.

The first is the orthopedic surgeon who felt the primary function of the heart was to pump blood to the bones.  How the heart actually worked? - - not a clue.

The second is the story of the doctors in an elevator.

As the door was closing someone was rushing to get aboard.

The internist put his hand in the door to stop it from closing.

The surgeon put in his head.

Some may have to think about the second one to get it, but I know you will understand.  Those of us who went into internal medicine specialties realize that there is little appreciation for thinking.  If you are in it for the money, go into a medical specialty where you do procedures.  Fix things with your hands.  Be a body mechanic.

Answer 2

I just work on the principle of what works, works.   But the smaller the view, the more it may miss the issues?

Answer 3

No, I don't think so if I understand the question.  The subspecialties only add knowledge about their area of expertise.  Most would still be capable GP's though I don't think I would want to test that theory.

Answer 4

It has been my experience that most GP's are trained in more than one field. Maybe not to the extent that they can treat patients without consulting a specialist but if a patient goes to a GP for chest pains the GP knows how to run an ECG and read the results to know if that patient needs to be referred to a cardiologist. Same for diabetics, depression, neurological problems etc. The GP knows a little of all the fields but not enough to treat most of them. My GP is an allergist and is a certified Psychiatrist as well. Most GP's can treat almost anything that comes along but has enough sense to know when to send a patient to a specialist. Is this what you were looking for? I know most people call an ECG machine an EKG machine but I was taught it is an ECG, Electro  Cardio  Gram, if I remember correctly  the Germans called it an EKG machine.

Answer 5

I see advantages here concerning the subspecialties ability to deal with *specific*, perhaps, commonly encountered issues well. As a result, perhaps cases considerd beyond a GP or the "common cold", but still fitting into a mold or that commonly encountered by the subspecialty should result in effective diagnosis and treatment. There may be fewer complications if the specific pathology falls within the "expertise" of the subspecialty. Perhaps, even in the face of high patient volumes. Hooray. So, if one has a common, singular problem that fits into what is common in a GP's experience or into what is common within a subspecialty, wellness is possible. Too bad this isn't often reality. A nice design, though, but it often doesn't always "fly".

Health issues that fall outside common borders, escape knowledge. If they didn't, a red flag would be waved; a GP would diagnose and treat or a patient would be referred, then be effectively and efficiently treated. So, chronic issues must fall outside of "design" borders.

The very term, chronic health problem, demonstrates to me that a said issue falls outside of, first a GP's knowledge, then at least the knowledge of a couple suspecialties, otherwise they wouldn't be chronic, would they? A nicely designed system, in actual practice, of initial assessment and referral has many cracks in it, which, I might add people fall through, which also go hand-in-hand with horrible consequences for the untreated patient.

From another angle, chronic issues, may not just escape knowledge, but may be chronic as a consequence of being multifaceted. A patient may get one problem deemed "common" to *someone*, attended to well, but IF others don't fall into the narrow knowledge base of the GP or specialist number 1, 2 or 3, etc, you are herded out, tossed to "someone with more specific expertise" to handle it. All the while, the patient? Still sick.

Often, puzzle pieces get lost too between subspecialties. Often no one is willing to sit down and put what is deemed the "complicated" pieces of a chronic illness all together. Laziness? Heedlessness? Apathy? Ignorance? I would have to say, yes to at least the some of these, otherwise, wouldn't someone just expend the energy and put an end to a patient's suffering? The whole is often in pieces in many records at many different specialist's offices. The GP having passed on the case to be dealt with more effectively "elsewhere", not wanting to get involved with that which is now out of his/her hands. Many times, though, too many places at once, results in "elsewhere" being nowhere.

Many reverberative ramifications of all the above, each to only the patient's demise: loss of one's job, secondary illnesses as a result of simply being undiagnosed (like depression), fianancial, emotional, social problems, all while the patient waits for someone with the knowledge to help. In many countries, there are VERY long wait times to complicate matters even more.

What I describe above does happen. Maybe not ALL the time. But, what *should* and what one *believes* typically occurs when subspecialities are called into "help" is just not the same as real experience. Hopefully, the majority have experiences closer to "intended design". Just too bad that not all well-intended designs work in actual practise.

EDIT: Yeah, good point. Misdiagnoses certainly add to the patient's S**t pile. An ill-informed hypothesis considered a done-deal in the mind of the physician, but, sometimes quite a different thing in terms of, well, the truth.

I think if someone "doesn't know", several terrible, far-reaching, long-standing, even irreparable consequences could be avoided if many more would at least try and find out before passing a case off to another....and, another, and another.

BTW: "Brain, WITHIN its groove" :-). Dickinson. I don't know what was meant by Dickinson, but my take was that we're divided by experience, lack of experience, and consequently much is missed and forever changed. So much rests on it; understanding, empathy, perspective, maybe ultimately what one can see. It can open and close minds. One can't truly know until they've known, type of thing...my personal interpretation is something along these lines, anyhow...

EDIT 2: I agree. They stick. They can often follow you and become a means to judge all other unrelated health problems in the future. Or, justified: "necessary 'attendants' to symptoms in order to reveal an ultimate diagnosis", "a valid diagnosis", even though it may have only been one that developed secondary to one's main problem. But, once the main problem is rectified it also dissipates, yet attention to it, remains. These exemplar scenarios are perplexing. Justification or as "judges" to weigh all else? Why? The nature of an ill-informed bias in a "single" mind? To avoid "being wrong", lawsuits? It happens, though, and not only is it erroneous, it's NOT sane, if you ask me.

About the poem. Thanx :-). I never knew about the intended meaning. In my teens and early twenties, I owned a really old, big book (about a foot thick) of poetry. I wonder where it went...Anyway, I'd read my faves over and over again; try and squeeze new meaning from them or envision different scenarios into which I imagined they'd fit. My all-time fave was T.S Eliot :-)

Answer 6

This is somewhat like the saying, "The operation was a sucess, the patient died".  Did you know that according to the standards of engineering that a bumblebee can't fly?  It's a good thing they don't know that.  Medical subspecialties often fall into the trap of being unable to see the forest for the trees, isolating their concerns and focus so as to lose sight of the individual and whole patient.  There needs to be some kind of a primary care provider who takes into account all of the contributions of the different specialties.  No one can possibly know all there is to know in the area of medicine, and none should pretend to.