Moments in Medicine at Michigan
David Miller, M.D., from Midland, is a fourth-year
resident in urology who is also pursuing a Masters of Public
Health degree in the U-M School of Public Health.
“Public health is focused at the level of populations, while clinical
medicine is focused on one-on-one interaction — what can I best do for
this one individual that I’m talking to at this point in time? There’s
the potential for those two ideals to be at odds, but I think that both disciplines
working together can accomplish so much more than having isolated interests
that come together less frequently.
David Miller, M.D.
Photo: J. Adrian Wylie
“Since I started to have involvement and responsibility in patient care
as a resident, I’ve come to recognize that taking a critical look at
what we do is essential. We’re coming to understand that there are measures
of health and disease beyond morbidity and mortality, which is historically
how we as a profession — and perhaps a society — have measured
how we’re doing as physicians. In many ways, those are really crude measures
because they don’t take into account a lot of what patients feel about
their condition, or a lot of the suffering that’s associated with disease.
“One of my goals is to move beyond the traditional measures of quality
in medical care. Skills like biostatistics and epidemiology, and other traditional
public health disciplines, are helping me accomplish that. Among my greatest
interests right now are urological cancers — prostate cancer, bladder
cancer, testicular cancer ... they all can have a dramatic impact on people’s
“There’s a difference between disease and illness. Illness is
more of a human phenomenon: someone has a disease, but how does that impact
that person’s life? Beyond the surgery, beyond the time when the disease
may or may not be cured, it’s important for physicians to recognize that
the illness can persist.”