Medicine - new or old

D V K Chao 周偉強
Editor, The Hong Kong Practitioner

The science and the art of medicine are difficult to separate. Despite rapid advances in medicine throughout the last decades, ranging from basic medical science to the actual delivery of health care, health outcome still depends very much on the interaction between the clinician and patient. Is the human part of the equation really that important?

In the 14th Dr Sun Yat-Sen Oration, Dr E K Yeoh reminded us of the contribution of advanced technology towards the modern health care delivery.¹ More importantly, Dr Yeoh raised the issues of the crucial roles of doctor-patient relationship and holistic medicine, both of which involve human interactions.

As modern technology develops rapidly, there is always the risk of over dependence on "high tech" on the one hand, whilst "high touch" would tend to be sidetracked on the other, replaced by "low touch", or being ignored all together. Judging from the literature and experience, the mutual trust fostered between the clinician and patient is essential in forming the therapeutic alliance in managing patient's complaints. Without a good doctor-patient relationship, even if we have the most competent doctor, the most up to date technology available, and the most advanced treatment modality ready at hand, there would be difficulty in reaching the best management plan together with the patient.

Communication is another crucial area highlighted by Dr Yeoh. It seems easy enough to understand that if one does not communicate well, then it would be difficult to achieve anything. However, it is also too easy to overlook the importance of reflecting on our own communication skills as clinicians serving our patients. How often does a busy doctor look at his or her verbal and non-verbal communication skills during day to day consultations with patients? It may be high time for the good old camcorder to get out from the capsule and demonstrate its worth to us. By recording and reviewing consultations from time to time, with the patients' consent, of course, clinicians could improve on the most essential aspect of their consultations - communication skills. Attending workshops on communication and role playing with colleagues are excellent ways to improve communication skills.

As frontline clinicians in the community, the approach of family doctors has stayed the same for centuries. The holistic, patient-centred, continuing care model has proven to be most successful and well received by patients globally. Despite the emergence of new technologies, new diseases and new treatments, the relationship between the science and the art of medicine will continue to be inseparable.