In Being a Doctor Hamish Wilson and Wayne Cunningham explore what doctoring is, bringing in elements often misunderstood or undervalued in medical practice, even though they are of vital importance.
They start by discussing the concepts of wellness, illness, and disease; suffering, healing, and curing; and how the doctor’s role, where cure is often not possible, is one of healing through facilitating ‘the patient’s movement towards wholeness and personal integrity’. Here is the need for a social constructivist as well as a biomedical approach: emotional as well as biomedical intelligence. Two particular examples bring these approaches to light. The first is the ‘heartsink experience’ where the awareness of transference and countertransference can assist in the understanding of what is going on for both the patient and the doctor. The second is how to approach illness where there is seemingly no disease, true somatisation, or where we have not yet been able to make a diagnosis.
The next part of the book addresses the culture of medicine, not always healthy; and adverse outcomes and patient safety with the need to put focus on systems rather than just individuals. In navigating all this the authors underline the importance of reflective practice, and the need for looking after ourselves as doctors. Finally comes a chapter on the place of the doctor in the future. There are challenges ahead and we need to involve ourselves in preparing to meet them. The key to a good healthcare system, reiterated throughout the book, is the coaching and mentoring of our undergraduate and postgraduate trainees in order to help them develop resilience, flexibility, healthy professional identities, and a supportive medical culture.
I found this to be an excellent book, well referenced and worthy as a key resource in undergraduate and postgraduate training. It also provides important reading to remind us all what the real role of a good doctor is. We live in a world where medicine is becoming increasingly industrialised and somehow we must get back to the centre of what doctoring truly is — being with our patients.