The fact that you are reading this newsletter tells me that you believe continuing medical education to be important. It also tells me that you have likely had a good education. The mark of a good education is the habit of life-long learning, not just for the practical knowledge accumulated, but learning for its own sake.
There was a time when life-long learning was a way of life for educated people. Many of the scientific, philosophical and literary achievements of the 17th to the 19th centuries were by amateurs. Up until the 20th century, philosophy was accessible to ordinary educated people and was a common subject of conversation in polite circles.
Ideas were exchanged and circulated in societies and through hand-written letters.
In the 20th century with the rapid increase in number and size of universities, colleges and technical schools, more and more people were able to find employment and devote their lives to study and research. Scholarship became the purview of specialists and amateurs only rarely were able to take part.
This has become especially true in medicine. Knowledge distribution has become a top-down exercise where specialists (usually from medical schools) dispense information to the less informed. During the twentieth century medical knowledge increasingly became the monopoly of specialists and the regulatory authorities that decide the standard of care.
However, another movement in the world of medical education has been taking place.
Medical knowledge is now readily available to everyone, even non-professionals.
Physicians see this every day in their practices where patients arrive with sheaves of Internet information on their own illnesses. It is not difficult for a patient to know more about a medical subject than his or her physician does.
The energetic and curious general physician can also learn more about a subject than the specialists who are supposedly expert in a field. Specialists' activities are often confined to a very small area of their field by the demands of sub-specialization. The generalist who sees a more diverse population may have far more experience in a given specialist's field.
To return to the subject of continuing medical education (CME), I believe a day is dawning where the truly educated physician (in the best sense) can again play an important role in medical care. This is in contrast to the current situation where physicians unthinkingly follow a mediocre standard of care, conform to algorithms and "guidelines", and treat their patients' numbers (blood pressure and cholesterol levels) with industrial pharmaceuticals.
The classical values and attitudes that make a good physician are the same as ever, but with the information revolution, the dependence on "experts" diminishes. (To be sure, experts can provide specialized technical expertise, but the general medical and scientific knowledge needed to provide wise, knowledgeable medical care is now widely available.)
So where does the educated physician go for continuing medical education? The answers are not obvious. Mainstream medicine in North America appears to have become the dispensing arm of the pharmaceutical industry and the CME offered by the universities and medical schools reflects that. So what else is available?
An alternative already appearing is the rise of non-university medical associations and societies studying non-standard methods of medical care. Associations studying functional medicine, heavy metal chelation, prolotherapy, orthomolecular medicine, ozone treatment, hypnotherapy and many other options are now part of the medical landscape. All of these function much as the 19th century scientific societies did. They attract the most intellectually alive physicians, those willing to think independently and those who are truly life-long learners.
At the recent "Mid-winter neural therapy retreat", the possibility of creating an organization to study and teach neural therapy in North America was discussed.
The consensus was that this is a desirable goal, but many practical difficulties must first be overcome. The first is to determine how many neural therapists exist in North America. The second is to assess their interest in such a project. The third is to gauge their level of expertise.
So, Dear Colleagues, I am asking that you let us know if you are interested, and in what category you belong: (This is only for those licensed to practice neural therapy.)
Robert F. Kidd, MD, CM