Hyposkillia: A sign of sagging medical profession-A pediatric perspective

The practice of medicine since Hippocrates, the father of medicine (460-377 BC) had the care of the patient in the core of its ideals which included scholarship; confidentiality, altruism and no harm doing. These ideals evolved from individual physician adoption to professional organization adoption. The medical profession used to have autonomy, prestige, and values centered on patient care. With societal changing values and the appearance of managed care and bioethics the medical profession lost its autonomy, prestige and self regulation. This led to widespread dissatisfaction among the profession members and reflected in deficiency in education and training of medical students and young physicians and resulted in deficiency of clinical skills required to deliver health care. This situation has been referred to as hyposkillia. This sagging has been reported in many countries worldwide and brought concern to many medical education authorities and societies. In this paper nine cases are reported to demonstrate that hyposkillia is also prevalent in our part of the world and show some deficiencies in the clinical skills that are avoidable. Inadequacies in: accurate history taking, complete appropriate physical examination, pertinent investigation and sound critical reasoning in management planning, all precluded optimum health care delivery initially in these cases. Many professional and education authorities have suggested that the process of redemption of the medical profession should start before admission to medical school by change in admission requirements to include behavioral and social sciences, and that the curricula in the medical schools should be redesigned to meet the changing societal values and priorities. Teaching clinical skills should be a continuous lifelong learning process from the medical school through training and into practice. Modern technology is to complement and not to replace bedside teaching and the patient should remain the best teacher for the physician.