{"id":"b2d1e372-446f-47c9-8cf6-25e5c7b9e922","slug":"why-i-am-concerned-about-the-future-of-medicine","title":"Why I am concerned about the future of medicine","authors":["Clinton Frederick Miller II"],"abstract":"Background: The author reflects on a 35-year career in neurosurgery, expressing concerns about the future of medicine, particularly regarding overdiagnosis and overtreatment. Influenced by experiences at Duke University, the author highlights the importance of compassionate patient care and the ethical principle of 'Primum non nocere' or 'first do no harm.' Methods: The article is a reflective narrative based on the author's personal experiences and observations throughout their medical career. It discusses specific examples from the field of neurosurgery, including insights from the SPORT study on lumbar disc herniation and the treatment of glioblastoma multiforme. Results: The author notes that many medical conditions are self-correcting and that the emphasis on intervention often leads to unnecessary procedures. The SPORT study revealed that medical management can be as effective as surgical management for certain conditions, challenging the traditional approach to treatment. Conclusion: The author concludes that misaligned incentives within the healthcare system, particularly the fee-for-service model, contribute to a focus on interventions rather than patient-centered care. There is a call for a reevaluation of how physicians engage with patients, especially in end-of-life situations. Keywords: neurosurgery, overdiagnosis, overtreatment, patient care, fee-for-service, medical ethics, healthcare delivery, glioblastoma","thumbnailUrl":null,"publishDate":"2014-11-28T00:00:00.000Z","doi":"10.4103/2152-7806.145760","categories":["Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/b2d1e372-446f-47c9-8cf6-25e5c7b9e922/pdf"}