In the past one hundred years, science has become so advanced that it has effectively gone over our heads. We live in a sea of cell phones (like the image below) and flat screen televisions, but how many of us understand how these devices work? The breadth and depth of knowledge has outpaced even trained scientists, such that we now need an advanced degree to answer even the most basic of questions in a niche field. Nevertheless, the masses enjoy using emails and airplanes, substituting faith for understanding when it comes to how all these things work.
Nowhere is this more evident, and more dangerous, than in medicine. Here the gap between public and expert leads to the same blind faith, only with higher stakes. Some of us have a healthy skepticism, but as Americans we also want to buy the best outcome available. However, we don’t always understand what we’re buying.
Medicine is unique in that it is both art and science. Behind the mountain of long medical words is a set of guidelines appropriately called the “practice” of medicine. While the framework is supported by evidence, the art of medicine fills the gray areas. All sorts of factors are weighed here – patient’s overall health, social and economic factors, doctor’s experience and biases. This reality can lead to more complicated outcomes than a model of clear cut problems fixed by simple algorithms.
Medicine also has a limited toolbox, despite the public’s soaring faith in miraculous technologies. With some exceptions, the human body mainly heals itself. Medicine just tries to give it kicks in the right direction. We can’t always fine tune these kicks perfectly, which can create still new problems. We also can’t yet replace human organs with like-new results, as if they were car parts. Finally, medicine still has its share of knowledge gaps, where we’ve identified a cause for an ailment but are powerless to treat. These limitations can leave many patients with uncertainty and frustration, and their lofty expectations may go unmet.
The gap between layperson and expert is particularly dangerous in the case of healthcare because of the artistic component of medicine, and because of limitations in fixing a biological system. The sooner we learn that we’re not dealing with clear cut rules and man-made devices, the sooner we’ll realize our health is not a commodity that is always fixable for the right price.
Image Caption: Your body is much trickier to fix than one of these.