Why Should Doctors Read Medical Books?

Many of us were raised on the multiple-choice approach to knowledge. This method is frequently used for tests in medical school and on Board examinations. Too often, it is the fashion of teaching at the bedside as well: “Name three other things that present like …” or “List five etiologic factors in … .” One might object to calling this an approach to knowledge, saying that it does not produce literate, erudite, scholarly, intellectual, or polished physicians-words usually associated with the idea of knowledge. In fact, knowledge is not the word most often used to describe what is necessary to answer examinations, bedside quizzes, or even the questions of patients. What is wanted is information, and information is just what we get. Information is available everywhere you look or listen, it pours out at us from every crack and cranny. Make no mistake, I believe that this endless flow of information is marvelous, but there are problems.

Access to even the most technical information is inherently democratic; it is there for everyone. In fact, well-informed patients are no longer the exception. The effects of widespread dissemination of and easy access to information about medical science must give us pause. If the facts about medical science do the work in medicine, information about these facts should, like the Colt revolver of old, be the great equalizer, leveling distinctions between physicians and nurse practitioners, physician assistants, and even educated consumers. This implies that the physician is secondary in the care of patients: same science, different physician, same care. This ideological belief dies hard-witness the implications of the rise of practice guidelines and the call for evidence-based medicine.

The idea of an almost autonomous medical science is linked to the concept that physicians treat diseases, an understanding that held medicine in its thrall …