The Upstream Doctors: Medical Innovators Track Sickness to Its Source

The Upstream Doctors

By Rishi Manchanda. Argues that effective care for most illnesses requires understanding the social conditions of patients and that society needs to divert attention and resources—perhaps more than a third—to addressing their root causes. Physicians need to be technically competent, excellent listeners, and able to understand pathogenesis—especially when sickness is not caused solely, by a microbe or an accident or a readily identified genetic mutation. Most sickness is not caused by a single event or pathological process but by many of them in concert. And most of these causes are to be found far upstream of the etiologies taught in medical school and in teaching hospitals. Read more.