If you need to say you’re all about the patient, you aren’t

Sir William of Ockham has achieved a degree of mortality via the wide promulgation of an aphorism, now generally known at Occam’s Razor (I’ll use the more economical spelling). There are many iterations of the razor, but my favorite is this: “simpler explanations are, other things being equal, generally better than more complex ones.” That trips off the tongue more easily than, say, “plurality should not be posited without necessity.”

In any event, we all know the razor and repeat it often at tumor boards, mostly because it has the ring of truth and but also because it’s an effective windbag deflater.

Occam’s Razor came to mind the other day as I was discussing a complicated administrative issue with another doctor. I don’t mean the aphorism itself – messy administrative problems involving multiple parties rarely lend themselves to simple explanations – rather, the idea of a truism in medicine achieving enduring fame.

If I could coin something memorable and true, I could grab a measure of Occam’s reknown… of Reed Sternberg’s je ne sais quoi … of Sir Percival Pott’s I don’t know what.

At some point in the conversation, the other physician pointed out to me that he was all about the patient. He literally said, “I’m all about the patient.” Now, if I’m talking to a fireman, he doesn’t need to let me know that he’s “all about the extinguishing” – it’s not like I thought he was a Farenheit 451 fireman. Conversely, when a pro athlete who is holding out for more cash and thus putting his team’s success in jeopardy, says, “it’s not about the money.” It is.

If you’re a doctor, everyone assumes you’re a professional dedicated to a career of healing – the social contract is built upon the assumption that you’re “all about the patient.” But life gets messy, mortgage payments balloon, and Apple keeps making cool stuff that everyone in the family absolutely has to have. If you take that fork down the dark dirt road toward personal gain and away from your patient’s best interests and you feel the need to reiterate your selfless dedication to the patient, at least now we’ll have an aphorism to describe the sorry state of affairs.

I believe the most parsimonious formulation is this: If you feel the need to say you’re all about the patient; You aren’t. And that’s the Sharp Razor.

– Sanford C. Sharp is a pathologist.

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