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Restoring the role of patient-based inquiry

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・以前、アメリカの研究者が編集長に曰く: 何でも”Molecular”という言葉を付けると予算でもなんでもつくんだよ・・
・能率、臓器別、プロトコール、などに曝される研修医が次第に「患者本人・全体」という概念から離れていって仕舞う・・

などなど考えさせられる論考でした。

A distancing of basic scientists from inpatient medical services has impeded the development of informed scientific hypotheses about patients’ presentation and limited access to technologies for exploring any hypotheses that are developed. Whereas patients with unusual or complex illness were traditionally cared for by master clinicians skilled in critical thinking, their care is now managed by a cadre of highly specialized, organ-specific consultants who may be less inclined to think about cross-cutting mechanisms. Given these changes,trainees are increasingly exposed to a culture that values efficiency, clinical protocols, and specialized expertise over scientific debate and critical thinking — which raises the concern that future generations of physicians will have both little exposure to patient-driven inquiry and little interest in sustaining or strengthening this bridge.

http://www.nejm.org/doi/full/10.1056/NEJMp1712474?query=TOC

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