Medicine has always had a close relationship to the humanities. Hippocrates, for example, is one well-known figure of medicine who delineated that medicine is a humanist field. During a time when ancient medicine was usually unaided by scientifically proven treatments, physicians followed the advice of Hippocrates by placing importance on the patient rather than just the disease. Despite the lacking effectiveness of the treatments, these doctors strived to form healing relationships with their patients, understanding their needs, and helping them catalyze natural resiliency and mental strength.
Yet, in postmodern society, the relationship between medicine and science is rapidly changing. With the advancement of technology and scientific discoveries, science is now quickly progressing while leaving behind the humanistic approach to medicine. Furthermore, the results of such a gap do not necessarily engender positive outcomes.
Although modern medicine is more evidence-based than ancient medicine, it is often still considered dangerous. According to a BMJ study conducted by researchers at Johns Hopkins School of Medicine, medical errors rank as the third leading cause of death in the United States. These errors usually arise due to cursory physical examinations and patient narratives, highlighting the shortcomings of inadequate communication between the doctor and patient. For example, according to a study conducted by the Institute of Medicine (IOE) in 2000, faulty communication is a major contributor to medical mishaps. A research report published in Academic Medicine in 2004, supports this conclusion; the findings, “based on physicians’ reviews of medical records and their judgments of adverse events,” show that medical errors are often associated with faulty communication between doctors and patients.
As science progressed in medicine, the valuable doctor and patient relationship was lost in the application of medical knowledge and technology. How can the humanities help regain the humanistic dimension in medicine? What interdisciplinary approaches are needed to promote and forge connections between the scientific and humanistic cultures?
One way universities and medical schools are aiming to revolutionize medical education in the changing landscape of the 21st century is through launching classes in the medical humanities. For example, Medicine, Science, and the Humanities (MSH), a new interdisciplinary major, has been implemented to the undergraduate curriculum at Johns Hopkins University. Dr. Charles Wiener, a professor of medicine at the Johns Hopkins School of Medicine who assisted in directing the new major, believes that “making distinctions between science and the humanities are both arbitrary and potentially disruptive.” Instead, including classes that are interwoven with both cultures, such as bioethics or history of medicine, are more useful in changing the dynamics of medicine. According to Dr. Wiener, “the skills and knowledge to become a humanist physician are woven throughout the Hopkins medical curriculum,” and the new undergraduate MSH major attempts to bring the humanities and sciences together, not only for pre-medical students, but also for students interested in applying the medical humanities in other aspects of society.
The major change in the Medical College Admissions Test (MCAT) in 2015 reflects the importance of the exposure to the humanities even before matriculation to medical school. The exam has changed to include new sections on “psychological, social and biological foundations of behavior” and “critical analysis and reasoning skills.” The role of a physician stretches beyond scientific analysis and includes communication and comprehension of the human experience. The changes to the MCAT address this need for well-rounded doctors. According to the Association of American Medical Colleges, the newly implemented sections to the MCAT “are designed to help students prepare for a rapidly changing health care system and an evolving body of medical knowledge while addressing the needs of a growing, aging, and increasingly diverse population.”
The promotion of an interdisciplinary education at the undergraduate and medical school levels and the changes to the MCAT, with more social science focused content, reflect the importance of the humanities as an invaluable framework to a future physician’s education. The humanities not only play an important role in doctor and patient interactions but also are reflected in the changing health care system, as seen in the promising future of individualized medicine. Dr. Wiener was deeply involved in creating the “Genes to Society” medical school curriculum at the Johns Hopkins School of Medicine, which aimed to emphasize the combination of the patient’s intrinsic makeup and external environment as influences of health. In his own practice, Dr. Wiener treats every patient as an individual; “understanding the environment, responses, exposure, history of family of an individual patient constitutes a patient story,” and effective communication is a vital component for him to use the patient story as an essential contextual factor in deciding how to diagnose or treat depending on the circumstances. The progressing direction towards individualized health care is, therefore, present in both individual doctors and the medical school curriculum. Furthermore, advances in biotechnology and bioinformatics show promise for individualized medicine in the future health care system.
Although present medicine is much more advanced than ancient medicine in terms of scientific knowledge, the humanities relatively has little part in medical education today. Ultimately, medicine is an integration of both science and the humanities, and a stronger emphasis on the humanities would effectively enhance skills, such as critical analysis, communication, and teamwork, that help shape a more humanistic physician. Rather than requiring separate classes in the science and humanities departments, launching more classes that show how one complements the other would raise an entirely new way of thinking. The medical humanities aims to do just that. Implementing such an interdisciplinary education can stimulate a fresh set of minds that can competently challenge and adjust to the problems that health care faces in a rapidly changing society.