Physicians of the Future Will Be More Like Shamans

A lot of energy is being expended in readying physicians for the future, preparing them for the more intensive use of technology – AI, VR, AR, the Internet of Things and blockchain notable among the emerging trends impacting the digital health landscape. From a skill building perspective this makes good sense.

From the perspective of health practice as a healing craft, the future will be for those who are more intimately connected to the present and possessing of the qualities of wisdom and insight – let me explain.

Modern medicine has been incredibly adept at preparing physicians with the functional skills to meet the scientific demands of day-to-day practice. Great lore exists about the rigor of medical schools that run people through a grueling gauntlet of theory and practice – many years of schooling followed by a hazing-like initiation filled with sleepless, intensive nights working in medical settings. Added to this are the yearly requirements to meet the accrediting standards of continuing medical education. No doubt these same institutions will integrate the digital training as part of the readying processes for physicians. In a system dominating by a model of scientific materialism, one could imagine this kind of rigor in the practice of medicine – the white coat reflecting the purity of those clinically precise intentions – when you spend that much time in the “lab”, you earn your white stripes.

Missing from this great initiation process has been the focus on vertical development. Unlike horizontal development which focuses on skill building, vertical development is about expanding mindsets and supporting a shift in perspective — it fundamentally changes the way we think and behave. Mindset refers to the mental models one engages when we are thinking and inform one's overall sense of identity or ego. The ego or sense of “me”-ness is the aspect of self that makes meaning expand or contract, resulting in more self-aware or self-confining behavior. Think of vertical development in the context of health care as a process of continuing personal education. Historically physicians have attracted great attention around how they wield their egos, and rightfully so; we expect people in leadership positions to embody the capacity for great self and other stewardship. This means knowing and becoming friendlier with your own internal stuff, the seat of which is the ego.

In tribal communities, the Shaman was the steward of the health of the community. Thinking of the Shaman, many tend to imagine sorcery or witchcraft or someone touting cosmic powers; to the modern, scientific mind this may sound archaic, magical or purely mythical. The origin of the word is filled with a certain ambiguity, but there is some sense that in its original form it is associated with wisdom seeking and insight. For the sake of argument, we will assume these meanings.

Why is insight so important to the future of medical practice? Really it has always been important, but somewhat forgotten. The future will be as much about learning as it is about learning anew or a quality of remembering.

Anyone who practices medicine knows that it is a complex craft. The number of variables that inform wellness or sickness cannot be fully understood using a purely objectivist style of knowing; the quality and depth of the physicians own awareness directly impacts on how they are seeing the presenting reality. That quality, by osmosis, also impact how their client sees themselves. Beyond all of the external variables influencing the trajectory of the client, the quality of the interiors involved in making sense of that experience – physician and client alike – are also woven into the process.

The lack of focus on the quality and depth of the interior lives of physicians has been overlooked to the detriment of practice, mired in the notion that their function is to maintain clinical neutrality and forego their own personal biases. With everything we now know about how we make sense of the world, a purely objective disposition is impossible to achieve; the seer and the seen are forever entwined in a cosmic dance. With that in mind, we would be better served by supporting physicians in cultivating the insight to better understand how their interior lives are shaping their practice. We need to know that physicians are also great shamans – sources of great insight. That means that we need to accompany them as well in the process of knowing themselves.

If we want to ready physicians of the future, we need to more fully support them in becoming more attuned to what is informing the quality of their awareness, the maturity of their outlook, and how are those meaning-making orientations impacting on the trajectory of their supportive interventions. A physician’s capacity to deal with the increasing complexities of practice means that they need to also cultivate the foundational art of greater self insight. The future is, after all, simply the expression of how we show up in the present.