Would you rather that your doctor have excellent medical knowledge or medical judgment? Answer this question before reading on.
Patients are drawn to doctors and medical facilities who boast “cutting edge” medical knowledge and techniques. Medical judgement, which is much more important in my view, is barely mentioned.
Good doctors have great knowledge, but great doctors have superb judgment. Consider the following vignette that I hope illustrates why judgement means more than knowledge.
A patient is comes to the emergency room with abdominal pain. The physician refers him to two different physicians, Dr. Knowledge and Dr. Judgment. Which of these physicians would you rather see?
Dr. Knowledge: I recommend that your gallbladder be removed. I have trained in advanced robotic surgery which leaves only one very small scar. My complication rate is extremely low. Our operating room team is excellent. I am the only surgeon in the hospital who is credentialed in robotic surgery.
If you visited only Dr. Knowledge, then you would likely be very impressed with his credentials and would schedule the surgery with great confidence that you would receive excellent care. If you had family members with you, your conversation afterwards would mention how lucky you were to fall into the hands of such a talented surgeon. Before you belly up to the scalpel, let's hear from Dr. Judgement.
Dr. Judgment: After listening to your medical history and examining you, I don't think that your gallbladder is responsible. While I'm not certain what caused your pain, I do not think that you should have surgery and remove an organ that is an innocent bystander. Since you're feeling better now, let's just keep an eye on you for now. I'll see you in a month. If the pain returns, then call me right away.
I know which of these doctors I would want as my doctor. Medical knowledge, however, has a lot more sizzle than medical judgment. Look and listen to the advertisements from our area health care institutions. Knowledge sells. Do any of these sound familiar?
• “Our orthopedists can make your back pain go away with a painless treatment that takes only one hour.”
• “Make obesity history. Make our bariatric surgery team, your team.”
• “Our state-of-the-art oncologists specialize in giving second opinions. You deserve state-of-the-art care. Call us.”
Check in next week for Part II on why I think a physician with good judgement is a better doctor than Dr. Mensa.
This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.