Dear Dr. Roach: My college kid went to a march for science. What does it mean to be a scientist? I thought she wanted to be a physician. Are physicians scientists?
Dear P.C.: Scientists are committed to making observations and finding ways to measure what they see, formulating a hypothesis and finding a way to test their ideas. Physicians do that. Plus, the definition of “scientist” includes someone learned in science, and so a physician absolutely is a scientist. Traditionally trained physicians learn physics and chemistry, biology, biochemistry and molecular biology, and later, anatomy and physiology basics. This is a basis for understanding health and disease, and lets us to be ready to understand clinical medicine.
Although there are exceptions, most physicians are not investigators, who are creators of science for the sake of increasing knowledge. Practicing physicians use science to help others, and hopefully teach it to the next generation in some fashion. Many physicians also will publish unusual or instructive cases in the medical literature.
Advances in medical knowledge come largely from the investigators, less so from the practitioners. We need both in our society if medicine is to advance.
I hear a lot about the art of medicine, and I agree there are practitioners who are very skilled in dealing with people and who have creative ways of approaching clinical problems. However, the physician-as-artist can’t exist without being a physician-as-scientist first, in my opinion.
I’ congratulate your daughter on her desire to consider a career in science, including medicine.
Dear Dr. Roach: My husband has had the poops bad every day for almost a year now. He has been to three doctors and had a number of tests done, but no one can find out what is wrong with him. Do you have any advice about what could be wrong and how to make the pooping just stop?
Dear D.S.: Diarrhea is something everyone faces, and the number of possible causes is large. I don’t recommend treatment to stop the diarrhea without knowing what is causing it. When I hear about diarrhea going on this long, I worry about problems with absorption (such as celiac disease). In people with blood or mucus in the diarrhea, I’d consider inflammatory bowel disease and recommend a colonoscopy. In people whose laboratory testing suggests it, the diarrhea might be caused by chronic infection or by a chemical secreted by a tumor, such as carcinoid. This is, figuratively, just the tip of the iceberg.
It does not sound to me as though he has had a proper evaluation; I’d recommend visiting a new gastroenterologist, a specialist in the GI system. Hopefully this doctor will take the time to methodically evaluate his issues and come up with a diagnosis and a treatment plan.
Email questions to ToYourGoodHealth@med.cornell.edu.