Why Study Physiology?

Jul 17 / Drs. Bryan & Julie Walsh

If you're a clinician, there are few subjects, if any, more relevant to your clinical success than physiology.


Think about this. Diagnosis is everything. Sure, it's great if you're a nice person, a good listener, and make patients feel comfortable. And yes, colorful lab reports feel fun to look at and share with your patients. Of course a "system" within your practice, with slick marketing techniques to fill your roster sounds amazing. But, if you can't figure out what is going on with your patients, those things do not matter. Period.
Here's an example. A patient comes to you for fatigue, and you think its due to thyroid hypofunction. You recommend the latest, greatest hypothyroid protocol, complete with the hottest supplement trend on the market. You're excited. Your patient is excited. But three months later, they come back and don't feel any better. And on top of that, they're out a few hundred bucks. All because it was never hypothyroid in the first place.
Several research papers demonstrate just how vital physiology is for a practicing clinician.
This paper shows that of all the scientific disciplines – pharmacology, biochemistry, anatomy, physiology, microbiology, etc. – the longer a clinician was in practice, the higher they rated physiology as important.  In fact, among clinicians who practiced more than 25 years, physiology was the most valuable subject to them. 

"Physiology is the key that allows you to unlock answers that other people are arguing about"

-Bryan Walsh
Other papers have been done, for example, this one demonstrating greater clinical confidence among nurse practitioners having taken postgraduate biological sciences. 

Still, our favorite was an opinion paper entitled, Why Physiology Is Critical to the Practice of Medicine: A 40-year Personal Perspective.  

The paper is mostly geared to pulmonologists and better identifying the most frequently missed fatal diagnosis of a pulmonary embolism, but includes some significant points for all clinicians, such as:
"Accuracy in diagnosis trumps all other elements in clinical decision making. If diagnosis is inaccurate, management is likely to prove futile if not dangerous. Solving clinical mysteries depends on a clinician's power of imagination and not the capacity to recite an algorithm or apply a protocol." 

The entire paper is worth reading, but the central premise is that while evidence-based medicine, protocols, algorithms, and randomized controlled trials have their place in medicine, we've gone too far with them and need to focus more on physiology as our primary road map to be better, more successful clinicians.   

Perhaps instead of another new lab test, expensive supplement, or cool new pathway, we need to shift our focus to having a solid understanding of physiology to improve our clinical practice.