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OPINION
Peter Drucker, 1909-2005
SAVE THE DATE
Noon, March 13
UTHSCSA
Dr. Richard Gunderman
Medicine at a crossroads:
By Richard Gunderman, MD, PhD
Today American medicine stands at a daunting crossroads. Solo earned a doctorate in international law. He then went to England
and small physician practices are being assimilated by large groups and worked as an economist at a bank before immigrating to the
and hospitals. The perspectives of individual physicians are being United States and becoming a university professor, writer and busi-
devalued in favor of general guidelines and algorithms. And the ness consultant.
locus of much medical decision-making is shifting away from the
patient-physician relationship toward systems and payers. Drucker’s output as a writer was prodigious and included 39
books, hundreds of academic articles, and a regular column in The
Albert Einstein once said that the problems we face cannot be Wall Street Journal for more than a decade. He also consulted for
solved using the same patterns of thought that were used to create many top U.S. corporations and innumerable nonprofits, often
them. In confronting contemporary medicine’s quandary, we need serving the latter clients gratis. He also was a highly sought-after
to look beyond the boundaries of the profession for deeper insights lecturer. Drucker died in 2005 at the age of 95.
into the nature of the problem and the range of solutions that are
available to us. Perhaps Drucker’s greatest work was also one of his first, an article
on the Danish philosopher and theologian Soren Kierkegaard, whose
INTELLECTUAL HOUSEHOLD writings Drucker had devoured when he first encountered them at
In this spirit, we turn to Peter Drucker, the 20th century’s most the age of 17. His essay, “The Unfashionable Kierkegaard,” was writ-
ten in 1933, during the age of Stalin and Hitler. Though not obvi-
widely influential, highly regarded and oft-quoted management ous, the insights it offers contemporary medicine are profound.
expert. Drucker was born in 1909 in Austria, the son of a physician
mother and attorney father, and he grew up in a richly intellectual Drucker’s reading of Kierkegaard convinced him of two things.
household that served as a meeting place for prominent thinkers First, those who expect technology or politics to produce a perfect
of the day. society – and for our purposes, a perfect practice of medicine or a
perfect healthcare system – are certain to be disappointed. Second,
As a young man, Drucker moved to Germany to start a career the more a society – or the profession of medicine – defines success
in business, then switched to journalism, a job that required him in strictly economic terms, the more it ends up losing itself.
to file no fewer than eight newspaper stories per week. He also
On one side of this conflict stands the French political philosopher
22 San Antonio Medicine • March 2015
