Chris Julsgard's Midterm Report Essay/questions

          Medicine is a practice, but also an art. Practicing medicine requires you to be clinical, to shut off your feelings and save a life. However, medicine contains an overwhelming number of unique circumstances where compassion and understanding make all the difference. In my reading of "Being Mortal: Medicine and What Matters in the End" by Atul Gawande, (chapter 7) I encountered many points that are relevant for this course, and stuck out to me as an aspiring physician. This balance between education and understanding was a major underlying theme in this chapter. Atul Gawande describes three different types of mindset a doctor typically uses when discussing care options with a patient.
          This first type of approach a doctor might favor is called the "paternalistic" doctor. This doctor assesses the patient's symptoms and selects the treatment option based upon those. There are likely other treatment options available, but this doctor assumes control and guides this patient down the path he or she deems best. This approach has lost popularity in recent years, but used to be the go-to  for physicians. I suspect the reason for this decline is usage is because of the likewise decline in the "doctors know best" mentality of the masses.
          The second type of approach Atul Gawande describes is the "informative" approach of a doctor. This approach is characterized by a doctor that explains multiple options of treatment, and takes a very "hands off" approach. They work with the patient and discuss what treatments would be most viable. This mindset is most prevalent in doctors today. This likely has to do as well with the surge in medical information available to the public. As education increased, the mystique/ grandeur of the physician faded, and people demanded an interaction with doctors to be on more equal terms.
          The "interpretive" physician is the third approach, and is certainly the most difficult for a physician to establish. This approach involves a doctor helping the patient determine what they actually want. Questions are asked like "What worries you", or "What is most important to you", and find which treatment matches your priorities. This doctor is focused solely on quality of life preservation. This is tricky because the approach requires a physician to think on a far larger scope of just the challenges a disease presents. The doctor must work with the patient to understand not just their priorities but also the root of these priorities and help select a plan that may not necessarily involve direct treatment to achieve the best quality of life.
           During my reading, (and also during Josiah's report) I found myself challenged to define what I think a physician should be. The closest I came to putting words to it ended with this result: I see a doctor as a person at a crossroads. This person is here to educate the passerby as to which paths lead where, and to illuminate paths that are unknown to the traveler. I suppose I most identify with the informative doctor, but specifically for end of life care, I can see the value in the interpretive approach as well.

Questions to be answered during presentation:
1: What chapter does this presentation cover?
2: What are the three types of approaches doctors utilize according to Atul Gawande
3: Which approach sees a decline as the "doctors know best" mindset has faded
4: By 2030, 1/2 or 2/3 of people worldwide will be essentially ______
5: ____ of people today die in their home, or in the assisted living center that has become their home