Arc of Medicine: Historical Threads

Histories of medicine tend to follow one of five threads.

The first traces the ebb and flow of medical schools. The second follows the regulatory sphere of organized medicine, its boards, its societies, and its licensing structures. The third recounts the history of teaching hospitals and residencies. The fourth celebrates the towering luminary physicians whose names attach to signs and syndromes.

The fifth thread is the practice of physicianship itself, a comprehensive account of what it has meant to be a physician, and of what it might mean next.

That last thread is the subject of this report, and prior efforts have most often neglected it. Many capable bodies have examined the profession's future, among them the AAMC-HHMI Scientific Foundations for Future Physicians, the AAMC workforce projections, the National Academies' work on graduate medical education, the ABMS Vision for the Future Commission, and the AMA's ChangeMedEd initiative. This work builds on those efforts and does not duplicate them.

Yet solution-oriented discourse in this space has been largely incremental, siloed, and accompanied by little conversion to action, and that judgment exempts none of the institutions from which this report's authors come.

The neglected thread requires sustained, well-resourced attention, and physicianship per se, projected forward instead of described backward, should become a legitimate object of scholarship and of strategy.