In the world of modern medicine, advanced technology often takes center stage. We are now focusing more on lab tests, imaging scans, and standardized treatment protocols to make medical decisions. But in this fast-moving system, one vital skill is often overlooked, and it is prognostication.
Dr. Bernardo Gutierrez, a retired physician with nearly five decades of experience, believes it’s time for medicine to come full circle. His new book, Prognostication: Principles and Practice, makes a compelling case for why this lost art should be at the heart of every doctor’s decision-making process.
But what exactly is prognostication? And why does it matter so much? Let’s break it down below.
Prognostication is More Than a Prediction
Prognostication is the process of finding out the most likely outcome that can happen to a patient given their current condition, medical and life history, age, and strength. It is more about understanding each patient and offering personalized expectations about the recovery, decline, or end-of-life.
Prognostication is personalized and thoughtful. It goes beyond diagnosis and treatment to ask: What is this person’s likely path? What kind of care will really help them? And what might cause more harm than good?
Why It’s Often Missing in Modern Medicine
Today’s healthcare system leans heavily on protocols, metrics, and interventions. These tools are useful but they’re designed for averages, not individuals. When doctors are pressured to “do everything possible,” they may end up ordering tests, procedures, or treatments that don’t actually benefit the person in front of them.
Dr. Gutierrez argues that this system can depersonalize care. In many cases, the care delivered may be technically advanced but emotionally empty, or worse, it may prolong suffering without improving quality of life.
Prognostication brings humanity back into the conversation. It reminds readers that the aim of treatment and medicine is to support life in a meaningful way, not just fighting death.
The Benefits of Prognostication
- Helps Doctors Make Better Decisions
Prognostication helps doctors weigh the possible outcomes of a treatment for a patient. For example, a frail elderly patient with multiple chronic illnesses might not benefit from aggressive surgery because of his age and comorbidities. Prognostication helps physicians recognize when the risks outweigh the benefits and choose a course of action that aligns with the patient’s reality. - Improves Communication with Patients and Families
When families realize that a loved one’s condition was terminal all along, it is one of the most painful moments. Prognostication gives doctors the confidence to have honest, compassionate conversations early on. It’s not about giving up hope; it’s about giving people clarity, choices, and the chance to prepare. - Prevents Futile Care
In the book, Dr. Gutierrez focuses on the importance of avoiding “futile care”. The term, futile care is used for treatments that may extend biological life, but don’t improve comfort, dignity, or outcomes. Prognostication helps identify these moments and shifts the focus toward palliative care, quality of life, or even just simple human presence. - Reduces Burnout for Physicians
These days, doctors face enormous pressure to deliver perfect outcomes. When they can’t, many feel guilt or disillusionment. Prognostication offers a healthier framework for such doctors: one rooted in realism, responsibility, and acceptance of what medicine can and cannot do. As Dr. Gutierrez writes, “Doctors need to differentiate when they are prolonging life from when they are prolonging the process of dying.”
A Skill That Can Be Taught and Must Be
Despite its importance, prognostication is rarely taught in medical schools. Many young doctors enter the field knowing how to treat a disease, but not how to assess a patient’s life trajectory. This gap leads to decisions that may be well-intentioned but ultimately harmful.
Dr. Gutierrez, who also served as an assistant professor of medicine, calls for prognostication to be a core part of medical education. It’s not just a clinical skill, it’s an ethical one. By teaching future doctors to think critically about outcomes, we can raise a new generation of caregivers who are not only smart but also wise.
It’s Time to Reclaim the Human Side of Medicine
Prognostication: Principles and Practice is more than a guidebook; it’s a call to action. Dr. Gutierrez speaks not just to doctors, but to anyone who has witnessed the disconnect between modern medicine and meaningful care.
He challenges us to ask hard questions:
- Are we treating the disease or the person?
- Are we healing, or are we simply intervening?
- What does dignity mean in the face of aging, decline, or death?
The answers may not always be easy. But with the skill of prognostication, we at least have a compass to guide the way.
Final Thoughts
In a system that often values speed, volume, and intervention, prognostication is a quiet but powerful act of wisdom. It invites doctors to pause, reflect, and see their patients not as cases to solve, but as people to walk alongside.
For physicians, caregivers, educators, and patients alike, Prognostication: Principles and Practice offers a timely and much-needed rebalancing of what modern healthcare should be: smart but also kind, honest, and human.
Want to explore Dr. Gutierrez’s full approach to compassionate, personalized care?
Order your copy of Prognostication: Principles and Practice today on Amazon.