I'm Quitting Medicine!

Yup, I caught you with my clickbait.

            Just five days before taking the Hippocratic oath, I have decided to quit “medicine”. Not in the sense that I am putting to waste 6 whole years of rigorous study, but I am in a way letting go of my proclivity to conform to the norm in medicine. To put it simply, the norm is to adopt the biomedical model of practice, choose a specialty (maybe even subspecialize), and be comfortable with a triple digit salary while practicing a field you know inside out. Now I don’t believe there is anything inherently wrong with the biomedical model, instead, the understanding that the human body works as a biological machine has brought about massive advances in our understanding of disease processes, and in turn, its cure. There is nothing wrong either with (sub)specializing, we need retina degeneration experts, rhinology allergist, even those that focus on just treating blood cancers on the lymphoid lineage. The field needs to be advanced and individuals with rare and highly complex cases deserve competent physicians who can handle them thoroughly. The case I am making is, if everyone strives to be a very specific specialist (which in many cases takes double the amount of time to be a generalist), then Indonesia must wait a few thousand years to have enough doctors to treat 300 million livers, 600 million eyes, 1.2 billion limbs,….. you get the point, this mindset will only widen the gap between supply and demand in the healthcare system. Let’s take a stroll in my funky head and examine what I think is a more useful mindset.

Building and reflecting on Engel’s biopsychosocial model (which I think is a great step towards what I am formulating), let us try and see the world as an organism and humans and their societies as constituent parts (just like this tiny human in the middle of the forest). Perhaps, individual diseases seen at the specialty clinic are just signs of community diseases, just as clinical signs point to the presence of individual diseases. Quite possibly, there is greater benefit in investing more in understanding this organism (in which you and I are just its parts) as a whole, and apply appropriate interventions. Then, thousands of diarrhea cases may be dealt with via better water sanitation, instead of training hundreds of pediatric infection specialists. On the same note, antimicrobial resistance may be handled by better regulations, instead of pushing money to train scientists and build labs to invent newer antibiotics. Of course, this cannot be generalized in all cases. You can't prevent breast cancer, although early screening implemented thoroughly by utilizing the systems in this organism can work wonders. You get it, this is an advertisement for public health degrees (advertisers can contact me for collaboration).

            My point is, there is much more to health than what most seem to perceive. Sure, it does involve targeted therapies and state of the art diagnostics, but it is so much more. I have not even touched on the intra personal interactions between the psyche and soma (commonly dubbed as medically unexplained symptoms,.. we don't know coz we view it only biomedically), maybe next time. This view has dragged me across many spectrums, possibly studying public health, environmental health, integrated internal medicine – psychiatry training, functional medicine, psychosomatic medicine. In short, it’s something like a witch doctor, but even weirder to the medical community. Let us see, but for now, I am quitting “medicine” and its common career stream. Have I perhaps convinced you to join my cult? :)

Yes mami, I won't be a plastic surgeon operating a beauty clinic,.. you can have your procedures elsewhere.