What are you?

This spring, I met with the administrator of a nonprofit group that hopes to increase science literacy through an extensive outreach effort to Maine’s libraries. Its current project is based on the human body. I had been invited to share my experience as a pediatrician and suggest how a visit to the doctor might serve as a framework on which to hang hands-on activities for school-age children.

Our entire population’s science literacy is embarrassingly deficient, and this sounded like an interesting project. But, as I walked downtown for the meeting, I began to question how much of what I did in the office would qualify as science. The administrator introduced herself, and after she told me the history of the group and about its successes and challenges, it was my turn. I began with a disclaimer.

"I was an art-history major in college. And although at some points I was trained by scientists, I don’t consider myself one." Once she had digested what was to her a surprising revelation, we brainstormed for an hour that I hope will result in some stimulating activities that will further the group’s mission.

As I walked back home, I began to wonder whether my perspective on the role of science in my work would have been a surprise to other physicians. And, if I wasn’t a scientist, what was I?

My 1968 edition of Webster’s New World Dictionary defines science as "systematized knowledge derived from observations and experimentation to determine the nature or principles of what is being studied." While I try to be observant and learn from my observations, I don’t have a system. I’m certainly not doing any controlled and reproducible experiments. "Anecdotal" pretty much sums up my observations.

Although I know that some of you are involved with other physicians in small groups doing office-based research, most of us are not. And those of you who are members of very large groups such as Kaiser-Permanente are contributing data to large-scale inquiries that certainly qualify as science. However, I’m not sure that as data collectors, you would claim to be scientists.

While it may not qualify as true science, most of us have done our own little uncontrolled "experiments" in which we try a different therapy if the one we have used a few times doesn’t seem to have been successful. But the practice of medicine is becoming more centralized. Care maps, algorithms, templates, and checklists have reduced the practice of front-line medicine to little more than following evidence-based cookbooks. Many of these changes have resulted in better outcomes as measured by death and complication rates. Even if our little "experiments" were only yielding pseudoscience, this shift to standardization has eliminated them, and squeezed intellectual curiosity out of the professional lives of most physicians.

So if we can no longer claim to be scientists, what would we like to be called? I guess we can legitimately qualify as "practitioners," or one of my least favorite words, "providers." The term "doctor" doesn’t really do much for me anymore. The privilege of posting two or three extra letters after one’s name doesn’t imply much more than the person has had the stamina to stay in school longer than most people with good sense. And "doctor" unfairly excludes skilled nurse practitioners.I returned to Mr. Webster for my own answer. He says that an artist is "a person who does anything very well, with a feeling for form, effect, etc." While a medical education must include information that can be discovered only by scientists, armed with that knowledge, it is up to the individual to apply it with sensitivity. I can think of no greater praise for a physician than to say, "He was an artist."

Dr. Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine. E-mail him at [email protected].

This spring, I met with the administrator of a nonprofit group that hopes to increase science literacy through an extensive outreach effort to Maine’s libraries. Its current project is based on the human body. I had been invited to share my experience as a pediatrician and suggest how a visit to the doctor might serve as a framework on which to hang hands-on activities for school-age children.

Our entire population’s science literacy is embarrassingly deficient, and this sounded like an interesting project. But, as I walked downtown for the meeting, I began to question how much of what I did in the office would qualify as science. The administrator introduced herself, and after she told me the history of the group and about its successes and challenges, it was my turn. I began with a disclaimer.

"I was an art-history major in college. And although at some points I was trained by scientists, I don’t consider myself one." Once she had digested what was to her a surprising revelation, we brainstormed for an hour that I hope will result in some stimulating activities that will further the group’s mission.

As I walked back home, I began to wonder whether my perspective on the role of science in my work would have been a surprise to other physicians. And, if I wasn’t a scientist, what was I?

My 1968 edition of Webster’s New World Dictionary defines science as "systematized knowledge derived from observations and experimentation to determine the nature or principles of what is being studied." While I try to be observant and learn from my observations, I don’t have a system. I’m certainly not doing any controlled and reproducible experiments. "Anecdotal" pretty much sums up my observations.

Although I know that some of you are involved with other physicians in small groups doing office-based research, most of us are not. And those of you who are members of very large groups such as Kaiser-Permanente are contributing data to large-scale inquiries that certainly qualify as science. However, I’m not sure that as data collectors, you would claim to be scientists.

While it may not qualify as true science, most of us have done our own little uncontrolled "experiments" in which we try a different therapy if the one we have used a few times doesn’t seem to have been successful. But the practice of medicine is becoming more centralized. Care maps, algorithms, templates, and checklists have reduced the practice of front-line medicine to little more than following evidence-based cookbooks. Many of these changes have resulted in better outcomes as measured by death and complication rates. Even if our little "experiments" were only yielding pseudoscience, this shift to standardization has eliminated them, and squeezed intellectual curiosity out of the professional lives of most physicians.

So if we can no longer claim to be scientists, what would we like to be called? I guess we can legitimately qualify as "practitioners," or one of my least favorite words, "providers." The term "doctor" doesn’t really do much for me anymore. The privilege of posting two or three extra letters after one’s name doesn’t imply much more than the person has had the stamina to stay in school longer than most people with good sense. And "doctor" unfairly excludes skilled nurse practitioners.I returned to Mr. Webster for my own answer. He says that an artist is "a person who does anything very well, with a feeling for form, effect, etc." While a medical education must include information that can be discovered only by scientists, armed with that knowledge, it is up to the individual to apply it with sensitivity. I can think of no greater praise for a physician than to say, "He was an artist."

Dr. Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine. E-mail him at [email protected].

This spring, I met with the administrator of a nonprofit group that hopes to increase science literacy through an extensive outreach effort to Maine’s libraries. Its current project is based on the human body. I had been invited to share my experience as a pediatrician and suggest how a visit to the doctor might serve as a framework on which to hang hands-on activities for school-age children.

Our entire population’s science literacy is embarrassingly deficient, and this sounded like an interesting project. But, as I walked downtown for the meeting, I began to question how much of what I did in the office would qualify as science. The administrator introduced herself, and after she told me the history of the group and about its successes and challenges, it was my turn. I began with a disclaimer.

"I was an art-history major in college. And although at some points I was trained by scientists, I don’t consider myself one." Once she had digested what was to her a surprising revelation, we brainstormed for an hour that I hope will result in some stimulating activities that will further the group’s mission.

As I walked back home, I began to wonder whether my perspective on the role of science in my work would have been a surprise to other physicians. And, if I wasn’t a scientist, what was I?

My 1968 edition of Webster’s New World Dictionary defines science as "systematized knowledge derived from observations and experimentation to determine the nature or principles of what is being studied." While I try to be observant and learn from my observations, I don’t have a system. I’m certainly not doing any controlled and reproducible experiments. "Anecdotal" pretty much sums up my observations.

Although I know that some of you are involved with other physicians in small groups doing office-based research, most of us are not. And those of you who are members of very large groups such as Kaiser-Permanente are contributing data to large-scale inquiries that certainly qualify as science. However, I’m not sure that as data collectors, you would claim to be scientists.

While it may not qualify as true science, most of us have done our own little uncontrolled "experiments" in which we try a different therapy if the one we have used a few times doesn’t seem to have been successful. But the practice of medicine is becoming more centralized. Care maps, algorithms, templates, and checklists have reduced the practice of front-line medicine to little more than following evidence-based cookbooks. Many of these changes have resulted in better outcomes as measured by death and complication rates. Even if our little "experiments" were only yielding pseudoscience, this shift to standardization has eliminated them, and squeezed intellectual curiosity out of the professional lives of most physicians.

So if we can no longer claim to be scientists, what would we like to be called? I guess we can legitimately qualify as "practitioners," or one of my least favorite words, "providers." The term "doctor" doesn’t really do much for me anymore. The privilege of posting two or three extra letters after one’s name doesn’t imply much more than the person has had the stamina to stay in school longer than most people with good sense. And "doctor" unfairly excludes skilled nurse practitioners.I returned to Mr. Webster for my own answer. He says that an artist is "a person who does anything very well, with a feeling for form, effect, etc." While a medical education must include information that can be discovered only by scientists, armed with that knowledge, it is up to the individual to apply it with sensitivity. I can think of no greater praise for a physician than to say, "He was an artist."

Dr. Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine. E-mail him at [email protected].