January Series (1/10): Abraham Nussbaum


Photo by Mary Taber

“Tinkering in Today’s Healthcare Factories: Pursuing the Renewal of Medicine”

In his January Series talk on Jan. 10, physician and writer Abraham Nussbaum examined three different ways to approach modern medicine, calling for a change in the way the field approaches patient care.

The approach our system has used up until recently viewed hospitals as a “fee for service” business, and its goal is for physicians to study the body as thoroughly as possible. He illustrated how this looks with his own experience as a kid going to the hospital with a broken arm — he was treated by one physician, who ran x-rays, casted his arm, charged his parents and sent him on his way.

Nussbaum then contrasted this with a recent trip to the same hospital when his dad had to get stitches. His dad was treated by six different people, who all asked him data-driven questions in order to evaluate him. After the trip, Nussbaum said his dad couldn’t name any of the physicians that treated him.

This approach is currently utilized in most of modern medicine and stems from recent health reform. It views the body as something that “produces” health and focuses on one outcome: making the body healthy. Physicians focus on data in order to diagnose and treat patients. This turns the hospital into a factory line and patients into objects to be fixed. A major issue with this approach, Nussbaum stated, is how it addresses chronic illness. Because patients with chronic illness cannot be healed, the desired “outcome” of the hospital is not possible.

Nussbaum went on to describe a person-centered approach, one that emphasizes creating a relationship and trust between the physician and the patient. For patients living with chronic illness, it helps patients learn and adapt to living in their body. Physicians are more focused on the joy of healing then the outcomes and are there to serve their patients.

This is the approach the first public hospitals used, and Nussbaum ended his talk by calling for its renewal. By becoming more person-centered, hospitals will give patients a better experience, developing trust and relationships between themselves and their physicians.