The Medicine of True Balance: Between Clinical Experience, Progress, and Responsibility

I am a doctor of the “old school.” I have studied, learned, taught, and above all, I have spent an entire lifetime striving to treat my patients in the best possible way, using the tools and knowledge available in each era, guided by the paths laid down by the many mentors I have encountered.

Luciano Bassani

Over time, I came to understand a simple yet essential truth: medicine is, and must remain, an art of balance. This concept, suggested centuries ago by Rav Moses Maimonides, known by the acronym Ramban (Cordoba 1138 – Cairo 1204), is more relevant today than ever.

We live in an era dominated by evidence-based medicine, advanced technologies, international guidelines, decision-making algorithms, and medico-legal pressure. Yet medicine cannot be reduced to mechanical protocols or digital reports: it is science, yes, but it is also experience, clinical judgment, and the ability to see the patient rather than just the disease—to understand that every person is unique, both in health and in illness.

Today, unfortunately, we are witnessing two opposite drifts. On the one hand, there are doctors and surgeons who have almost stopped “making diagnoses” (from the Greek diagnosis, meaning judgment and evaluation) in the true sense of the word. They have forgotten clinical practice: they no longer listen carefully to the patient’s story, they do not observe enough, they do not auscultate, palpate, or reason through the overall clinical picture. They rely almost exclusively on instrumental tests, as if these were making the diagnosis in place of the physician.

Moses Maimonide

Technology, originally conceived as a support for clinical reasoning, has gradually become its replacement. When we also consider the sudden emergence of artificial intelligence, the overall picture becomes concerning.

On the opposite end of the spectrum, however, lies another error: a form of medical obscurantism. These are professionals who distrust progress, reject innovation outright, cling to an idealised past, and forget that medicine has meanwhile made enormous advances. Today we have extraordinarily powerful diagnostic tools, targeted therapies, less invasive procedures, and life-saving drugs. Ignoring them is not a sign of prudence, but of irresponsibility.

For this reason, it must be stated clearly: one cannot be “against everything.” There are medications that genuinely save lives, antibiotics that prevent severe and potentially fatal complications, oncological therapies that have transformed outcomes once considered inevitable, and vaccines that have changed the course of human history. Rejecting these tools on principle is an injustice to patients.

A common cold may require nothing more than rest and an aspirin, but bronchopneumonia requires antibiotics and appropriate medical treatment. Back pain may be a simple degenerative condition, but it can also signal a fracture, a metastasis, or even referred visceral pain. Knowing how to distinguish between these situations is the very essence of medicine: it is not automatism, but clinical intelligence.

The true physician is the one who knows how to maintain balance: between doing too much and doing too little, between watchful waiting and intervention, between caution and decisiveness, and between respect for tradition and openness to progress.Every choice has consequences, and the physician’s duty is to take responsibility for them with competence, humanity, and ethical awareness. Moses Maimonides reminded us that health is born of harmony and moderation. The same holds true for the art of medicine.

The physician of today—as of the past and the future—must safeguard this balance between clinical practice and scientific evidence, between experience and technology, between science and conscience. Only in this way can medicine remain what it is meant to be: the care of the person, guided by intelligence, humility, and dignity.

Luciano Bassani