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Milestone #4 Acting the part: professionalizing the practice of medicine

  • “He must be clean in person, well-dressed, and anointed with fragrant perfumes that do not in any way cause suspicion...”
  • Hippocrates, Physician, 420-350 BC

Living in the twenty-first century AD, it is difficult to imagine how healers in the fifth century BC conducted their daily business. However, it seems reasonable to assume that between the priests and their incantations and various peripatetic healers with their non-FDA approved ointments, the practice of medicine was fairly loose by today’s standards. In various books and writings, Hippocrates changed this, too. Raising the practice of medicine from a common trade to a profession with rigorous standards, he provided advice in virtually every arena of medicine.

For example, recognizing that not everyone is cut out for medical training, Hippocrates cautions in one book:

  • “Whoever is going to acquire truly an understanding of medicine must possess the following advantages: natural ability, instructions, a suitable place for study, tuition from childhood, industry, and time. First of all, natural ability is required, for, if nature is in opposition, all is in vain.”

In another text, he describes a range of physical and personality traits physicians need to possess to successfully practice medicine:

  • “The authority of a physician requires that he is of healthy complexion and plump as nature intended... Next, he must be clean in person, well-dressed, and anointed with fragrant perfumes that do not in any way cause suspicion.”

In another text, however, Hippocrates cautions against the perils of vanity:

  • “You must also shun luxurious headgear with a view to procuring patients, and elaborate perfume too.”

What’s more, the physician must be mindful of demeanor and the appropriate boundaries of laughter. “In appearance he must have a thoughtful but not harsh countenance; for harshness seems to suggest stubbornness and misanthropy. But, on the other hand, the man of uncontrolled laughter and excessive cheerfulness is considered vulgar. Such a disposition must especially be avoided.”

And what patient today would not be reassured by Hippocrates’ formula for bedside manner?

  • “When you enter a sick man’s room...know what you must do before going in... On entering, be mindful of your manner of sitting, and your reserve, your decorum, authoritative demeanor, brevity of speech, your composure, your response to objections, and your self-possession in the face of troublesome occurrences.”

As for the occasional troublemaker, Hippocrates advises,

  • “It is necessary also to keep an eye on the patient’s faults. They often lie about taking the things prescribed [and] die through not taking disagreeable potions.”

Despite his stern advice, Hippocrates’ underlying goodwill is unmistakable:

  • “Give what encouragement is required cheerfully and calmly, diverting his attention from his own circumstances. On one occasion rebuke him harshly and strictly, on another console him with solicitude and attention.”

And finally, when it comes to the sensitive issue of billing, Hippocrates reveals a spirit both sympathetic...

  • “One ought not be concerned about fixing a fee. For I consider an anxiety of this sort harmful to a troubled patient. It is better to reproach patients whom you have saved than to extort money from those who are in a critical condition.”

and charitable...

  • “Have regard to your patient’s means or wealth. On occasion, give your services free, recalling the memory of an earlier debt of gratitude...”
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