Advances in internal medicine reshape Australia's healthcare, altering practice, culture, and patient care.

This book traces the remarkable advances in internal medicine that took place during the medical career of the author. Large part medical history and small part memoir, the book proposes that the extent and pace of these advances far outstrip any previous advances made in medicine and that the advances have contributed to a striking increase in life expectancy in Australia. In addition, in only five decades, Australia's large public hospitals were transformed into world class academic institutions. These advances have come with several negative consequences and the second half of the book addresses many of these issues. They include the fragmentation of the practice of medicine, increasingly stressful elements of the lives of junior doctors in training, and distortion of the remuneration structure of medical practice which may be deterring new medical graduates from entering general practice. Advances in technology and associated specialisation may also have undermined crucial components of good medical practice, especially the need to always consider the whole person and to seek to practise humane medicine. Over these fifty years, other undesirable changes have crept in to the practice of medicine. These include the deregulation of advertising by doctors, the commercialisation of medical practices, the fear of medical litigation (and the associated stress of the dealing with adversarial legal system in such litigation) and the over-regulation or heavy-handed regulation of the medical profession.