Doctors with Stendhal Syndrome?

I recently came across an intriguing piece in The New York Times by Harvard professor Jerry Avorn. He suggested that today’s physicians suffer from Stendhal Syndrome because of the abundance of medical evidence and clinical guidelines. Avorn introduces the malady this way:

During an 1817 visit to Florence, the French author Marie-Henri Beyle, known by the pen name Stendhal, was seized by palpitations, dizziness and a feeling of being overwhelmed by the abundance of great art surrounding him; an Italian psychiatrist later coined the term Stendhal syndrome to describe this phenomenon.

I agree with the abundance of evidence and opinions confronting today’s physicians, but I hardly find it as awe-inspiring as a trip to Florence, as the author suggests. To paraphrase Lloyd Bentsen: I know Florence, and this is not Florentine art.

Avorn continues:

We physicians are susceptible to a kind of medical Stendhal syndrome as we confront the voluminous evidence about the clinical choices we face every day. It would take dozens of hours each week for a conscientious primary care doctor to read everything he or she needed in order to stay current — a dizzying and impractical prospect.

To remedy the problem, many medical groups issue clinical-practice guidelines: experts in a field sort through the reams of clinical research on a medical condition and pore over drug studies, then publish summaries about what treatments work best so that physicians everywhere can offer the most appropriate, up-to-date care to their patients.

While this sounds straightforward, the process can go astray…

Professor Avorn offers many examples of misguided guidelines, but he doesn’t seem to draw the conclusion this country doctor has drawn from all of this: If you read The New England Journal of Medicine, the Journal of the American Medical Association, The Lancet or The British Medical Journal and the Health pages of The New York Times or The Wall Street Journal, and attend your required Continuing Medical Education sessions, you can see through many of the guidelines that pass for Gospel in our times. And it is not necessary to be the first one to adopt new ideas, just don’t be the last one!

I don’t think we physicians should allow ourselves to be compared with Stendhal, who – as Professor Avorn did point out – didn’t actually collapse because he was so taken with Florence. He suffered severe side effects from remedies he was taking for syphilis, a disease known to attack and destroy the central nervous system!

http://www.nytimes.com/2013/06/12/opinion/healing-the-overwhelmed-physician.html?_r=1&