Flexner%20Report%20Study%20Guide
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University of South Carolina *
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321
Subject
Medicine
Date
Apr 3, 2024
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Pages
2
Uploaded by CoachMorningGoldfinch36
Hannah Davis
(1) How is modern medicine distinguished from earlier "dogmatic" and "empiric" stages?
Explain the essential aspects of each of the three stages, and how later stages arise out of
earlier ones. What is wrong with each of the two preliminary stages? (HINT: see pp. 52-53)
In the dogmatic stage, tradition was a central aspect that was upheld in the medical field.
Knowledge of medicine was mostly theoretical and relied on conjecture rather than evidence.
The education given was inconsistent and lacked exposure to actual clinical care and
professional oversight. In the empiric stage, observation was a key trait. Even though people
had more hands-on experience, there was still a superficial understanding of the curricula and
nothing was really in depth. Even though there was observation, there was a lack of
discrimination. There was an inability to analyze what was observed. Like the dogmatic stage,
the empirical stage still lacked a structured curriculum and standard practice. In modern
medicine, there is a strong emphasis on scientific principles. Modern medicine is based on
experimentation and research. There was an advancement in technology, techniques, and
pharmaceuticals. Education is now highly regulated and must meet strict standards in order to
acquire the necessary skills and knowledge. Later stages arised from the earlier stages
because of the accumulation of knowledge and technological advancements. The text states on
page 53, “On the pedagogical side, modern medicine, like all scientific teaching, is
characterized by activity. The student no longer merely watches, listens, memorizes, he does.”
These stages involved radical reconstruction of the systems they used.
(2) How is a physician supposed to "work up" a case and reason through it? Try to put yourself
in the mind of a physician, and imagine working up a case in the way Flexner says a physician
should. (HINT: Flexner provides a clear overview of how the physician is to use the scientific
method in working up a case on p. 55.)
A physician uses a systematic approach to a case just like a researcher does in an experiment.
Flexner emphasizes the need to acquire an extensive history of the patient including past
medical history, illnesses, and even familial medical history. The patient’s history is like a
researcher's data as stated on page 55, “The patient’s history, conditions, symptoms, form his
data”. After getting a history, the physician needs to do a thorough physical examination.
Thorough documentation needs to be made on the patient's history and any findings during the
physical examination. With all of this information, a physician can then use the data to analyze
and come up with a diagnosis. Evidence is used to come up with this diagnosis, as evidence is
used to come to a conclusion in an experiment. This methodical and evidence-based approach
is most likely how Flexner would work up a case as a physician. Flexner had an extensive
scientific method of working up a case. With this method, a distinction can be made between
certainty and probability.
(3) How is disease understood? Is this something experienced by patients? Some have said
that Flexner has a reductionist, mechanical model of the disease: it is like a defect in a body
machine. Is this an accurate account of the way Flexner views disease? To what degree is it fair
to accuse Flexner’s physicians of practicing in an uncaring way that focuses on problems of the
body, but ignores how illness alters the life of a person? (HINT: see, for example, pp. 58, 62-64,
66-67).
Flexner's view on disease comes from a perspective of reductionism and a mechanistic model.
He viewed disease as a biological malfunction of the human body. He emphasized
understanding diseases in terms of specific biological abnormalities or defects in the body's
functioning. He advocated for a rigorous scientific approach to medicine, which focused on the
identification and treatment of these underlying physiological and anatomical abnormalities.
While this approach emphasizes a deep understanding of disease, it doesn’t focus on the other
aspects we look for in a physician. This means a physician could be potentially neglectful
towards their patient using this more science based approach, and disregard the humanistic
elements that also play into the care of a patient. While Flexner's model of disease was
influential in shaping modern medicine, it's recognized that it had its limitations, particularly in
terms of its potential to sometimes overlook the broader impact of illness on a person's life.
Modern medical practice has incorporated a more holistic approach, recognizing that disease
affects not just the body, but the person as a whole.
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