Bengaluru: “Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less in human beings of whom they know nothing”, said Voltaire in the 18th century.

Magic and religion played a large part in the medicine of prehistoric or early human society. Administration of a vegetable drug or remedy by mouth was accompanied by incantations, dancing, grimaces, and all the tricks of the magician.

Therefore, the first doctors, or “medicine men,” were witch doctors or sorcerers. The use of charms and talismans, still prevalent in modern times, is of ancient origin.

Medicine has come a long way since those times. Advances in technology and treatment has reduced the morbidity and mortality associated with disease.

“Experience based medicine” has been replaced by “Evidence based medicine”. The world of medical science and academia has progressed so much that sometimes it is difficult to keep up with its pace.

Over the years what patients expect from their doctors has changed. This is due to patients being more actively involved in their care, a move away from the “paternalistic” practice of medicine and the empowerment of patients giving them a greater say in their treatment.

In the not so distant past doctors were placed on a pedestal and were highly regarded for their achievements, skill and dedication. Over time, sadly, this was replaced by mistrust and medical litigation.

No professional can be perfect, and this is true of medicine as well. Unfortunately, mistakes in medicine can cause morbidity or death. No doctor starts out wanting to harm and however hard he/she tries mistakes will continue to be made. The only thing that the medical profession can do is to try and reduce the number of mistakes.

Increasingly doctors face medicolegal action, rightly or wrongly for their actions especially if the outcome is bad. This has led to the increase in the practice of defensive medicine.

Many in the younger generation have opted not to pursue medicine as they have been put off by the spiraling violence against doctors and the increasing number of medicolegal cases against them.

Despite all this medicine does have its rewards. There are many gratifying moments which are unique to being a doctor. And it is such moments that keep good ethical doctors from becoming completely disillusioned.

(Author — Dr Prathima Reddy, MBBS, MRCOG (London), FRCOG (London), FACOG (USA) is the director, senior obstetrician and gynaecologist at Fortis La Femme Hospital, Richmond Road, Bengaluru)