What Would Osler Think?

January 30, 2012

Medicine is changing quickly.  In the context of these changes I hear this question occasionally: ‘What would Osler think?’ What would he think of imaging before examination?  How would he feel about medical residents rounding with one eye on the EHR?

It’s an interesting question and one that highlights the fact that we’re a profession preoccupied with our past.  We like to quote iconic figures of medical history.  Their pictures hang in the lecture halls that shape the youngest minds in medicine.  We’re trained from early on to keep pace with the past.  We cross-check where we’re headed with where we’ve been.

But I can’t help but wonder if Osler’s perspective on 21st century medicine might be irrelevant.  Osler was dependent upon his hands, eyes and ears because he had little else.  He lived and prospered within his diagnostic means.

But understand that the heroes we quote were the disruptors of their time.  Flexner, Osler, Debakey and others worked to overturn the status quo.   I suspect that if William Osler were here he’d push the limits of wireless health, imaging, genomics and self-quantification.  He would apply our digital tools as a means of engaging and advancing the interest of the patient.  His methods of connection would be unrecognizable to past generations but no less important.

That’s what Osler would think.  I think.

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Jody Schoger January 30, 2012 at 2:05 pm

As a patient, the first disruption to my worldview was meeting physicians who engaged in collaborative discussions about my cancer treatment. As a patient, having a doctor who hands me my data as a matter of course is now the norm. As a patient, I admire the innovators and rabble rousers as long as they retain their ability to talk to me at the moment I need to make a critical health care decision on behalf of myself or my family.

My answer reflects your post: when we’re treading new ground the first stop is to scan through past experience to see what coincides.

Since I’m not a physician I can’t address your wider point, but I was struck by what Abraham Verghese talked about last fall at Stanford: we’ve gone from gathering at the patient’s bedside for data to a computer terminal. At the end of the day, what will remain?

Thanks for a thoughtful post,

GlassHospital February 2, 2012 at 2:02 pm

Saw a version of the Verghese talk (he gave it at TED, among other places).
I was struck by the contrast between him and Dr. V here.

So I wrote about it:


-Dr. John

Carmen Gonzalez January 30, 2012 at 5:46 pm

The key to ethical technoligical shift, in my opinion, is to reflect on its proper use and place. To adopt the latest gadgetry without anticipating its darker aspects is to invite remorse. Thankfully, as a pioneer in the social media space, you are devoting yourself to such contemplation. It makes wireless health and other new digital technologies easier to assess. Thanks for your thoughtful insights.

Jan January 30, 2012 at 8:36 pm

I am certain Osler would embrace any technology that helped with efficient collection and ethical sharing of patients’ histories. I cannot help but wonder if he would still be as sexist and ageist.

Alex Djuricich January 30, 2012 at 9:50 pm

Wonderful comments, Bryan. Agree with you. Osler: disruptive innovator!

Salvador Casado January 31, 2012 at 3:10 pm

In Europe big National Health Systems are sinking. In USA a lot of citizens haven´t access to health services. The sea is the same for all. Only a few will be able to use the ship-wreck tables to surf.

Patients still need us.

M King January 31, 2012 at 8:57 pm

There is always a balance of art, history and exam for inquiry and decision versus the technology, endpoint testing and certainty. We are not at a point to afford all and much does not truely change the endpoint decision. A hard lesson for many physicians. In the same breath we are on the cusp of imploring technology/testing for customized medical therapy. Let’s hope we are smart enough when to utilize most effectively without bankrupting the system. I am certain that would be Osler’s position careful innovation, not to sacrifice the massive while optiming what is necessary to care for you patient.

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