Quixotic medicine: Physical and economic laws perilously disregarded in health care and medical education

David R. Haburchak, Bradford C. Mitchell, Craig J. Boomer

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Wise medical practice requires balancing the idealistic goals of medicine with the physical and economic realities of their application. Clinicians should know and employ the rules, maxims, and heuristics that summarize these goals and constraints. There has been little formal study of rules or laws pertaining to therapeutics and prognosis, so the authors postulate four physical and four economic laws that apply to health care: the laws of (1) finitude, (2) inertia, (3) entropy, and (4) the uncertainty principle; and the laws of (5) diminishing returns, (6) unintended consequences, (7) distribution, and (8) economizing. These laws manifest themselves in the absence of health, the pathogenesis of disease, prognosis, and the behaviors of participants in the health care enterprise. Physicians and the public perilously disregard these laws, frequently producing misdiagnoses, distraction, false expectations, unanticipated and undesirable outcomes, inequitable distribution of scarce resources, distrust, and cynicism: in short, quixotic medicine. The origins and public reinforcement of quixotic medicine make it deaf to calls for pragmatism. To achieve the Accreditation Council of Graduate Medical Education competency of systems-based practice, the authors recommend that premedical education return to a broader liberal arts curriculum and that medical education and training foster didactic and experiential knowledge of these eight laws.

Original languageEnglish (US)
Pages (from-to)1140-1145
Number of pages6
JournalAcademic Medicine
Volume83
Issue number12
DOIs
StatePublished - Dec 2008

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economic law
medicine
health care
Law
education
experiential knowledge
pragmatism
medical practice
entropy
accreditation
didactics
reinforcement
heuristics
physician
graduate
uncertainty
art
Disease
curriculum
health

ASJC Scopus subject areas

  • Education

Cite this

Quixotic medicine : Physical and economic laws perilously disregarded in health care and medical education. / Haburchak, David R.; Mitchell, Bradford C.; Boomer, Craig J.

In: Academic Medicine, Vol. 83, No. 12, 12.2008, p. 1140-1145.

Research output: Contribution to journalReview article

Haburchak, David R. ; Mitchell, Bradford C. ; Boomer, Craig J. / Quixotic medicine : Physical and economic laws perilously disregarded in health care and medical education. In: Academic Medicine. 2008 ; Vol. 83, No. 12. pp. 1140-1145.
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