Should applicants like "Dr. House" be allowed into medical school?

[Prometheus123]

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I heard that it was one engineer who knew about it, expressed their concerns to the other engineers to no avail, and we all know what happened after that. They were victims to group think. I hate working in groups because of this. You can know something that others don't, have the know-how to fix it, but lack the autonomy/power to make it happen. Thinking that you can have a group of people who are all equally as intelligent, sociable, emotionally mature is like Marx thinking that Communism could actually work. It's idealism created by academics who lack practical intelligence

Given that SDN is a self-selecting group of some of the most intelligent and hard-working people in the US, I imagine that most people on here feel this way sometimes.

My version of the story comes from business books, so it is possible it's mythologized a bit to fit the narrative. Let's assume your version is correct. It sounds like a House-like engineer had the knowledge to fix it, but he didn't manage to persuade his colleagues. Doesn't that underline how important it is to have both knowledge and people skills?

I know it can be frustrating sometimes, but think of it this way: if smart SDN members can learn to solve problems in difficult courses like Physics and Organic Chemistry, they can learn to effectively solve interpersonal, cultural, and political problems too. It's just another set of learnable skills.

 

[Goro]

Empathy is not learnable. We want students who bring humanistic domains into med school.

Given that SDN is a self-selecting group of some of the most intelligent and hard-working people in the US, I imagine that most people on here feel this way sometimes.

My version of the story comes from business books, so it is possible it's mythologized a bit to fit the narrative. Let's assume your version is correct. It sounds like a House-like engineer had the knowledge to fix it, but he didn't manage to persuade his colleagues. Doesn't that underline how important it is to have both knowledge and people skills?

I know it can be frustrating sometimes, but think of it this way: if smart SDN members can learn to solve problems in difficult courses like Physics and Organic Chemistry, they can learn to effectively solve interpersonal, cultural, and political problems too. It's just another set of learnable skills.

 

[Prometheus123]

Empathy is not learnable. We want students who bring humanistic domains into med school.

I agree it probably can't be learned from the ground up. I don't think that a psychopath could learn empathy, for instance. And that definitely makes sense that you'd want applicants who already have that trait well developed before entering med school. But I think most people have all the basic building blocks for empathy (mirror neurons, the ability to generate theory of mind), and we strengthen a neural network whenever we use it (neuroplasticity). So, I'd argue that most people can probably at least incrementally improve their ability to empathize with practice. I'd also argue that suffering and experience with suffering populations improves one's ability to empathize.

 

[Goro]

I agree it probably can't be learned from the ground up. I don't think that a psychopath could learn empathy, for instance. And that definitely makes sense that you'd want applicants who already have that trait well developed before entering med school. But I think most people have all the basic building blocks for empathy (mirror neurons, the ability to generate theory of mind), and we strengthen a neural network whenever we use it (neuroplasticity). So, I'd argue that most people can probably at least incrementally improve their ability to empathize with practice. I'd also argue that suffering and experience with suffering populations improves one's ability to empathize.

Again, we do NOT want to have to teach the unteachable. We want people coming in with it, and it's one of the reasons we require non-clinical volunteering. Applicants need to demonstrate their altruism.

Try reading some med school application pages and look for requirements. U UT has a very good example of this.

 

[Prometheus123]

Again, we do NOT want to have to teach the unteachable. We want people coming in with it, and it's one of the reasons we require non-clinical volunteering. Applicants need to demonstrate their altruism.

Try reading some med school application pages and look for requirements. U UT has a very good example of this.

I completely agree with you. I think empathy may be somewhat learnable, but it's definitely not teachable. I've come to appreciate the requirement for non-clinical volunteering for this very reason, because it can provide excellent evidence of altruism and empathy.

I will read the U UT requirements page. After scanning it, it does seem like an excellent description of how the activities demonstrate the intangibles.

 

[MonkeyArrow]

We want people coming in with it, and it's one of the reasons we require non-clinical volunteering. Applicants need to demonstrate their altruism.

But how does non-clinical volunteering demonstrate empathy? How many applicants would have no non-clinical volunteering on their applications if it was not a de facto requirement (and if we're assuming non-clinical volunteering wouldn't give you an advantage in any other way, like a hobby)? Or perhaps a better question, can a non-empathetic person/sociopath, even, rack up 100 hours of non-clinical volunteering?

 

[Goro]

But how does non-clinical volunteering demonstrate empathy? How many applicants would have no non-clinical volunteering on their applications if it was not a de facto requirement (and if we're assuming non-clinical volunteering wouldn't give you an advantage in any other way, like a hobby)? Or perhaps a better question, can a non-empathetic person/sociopath, even, rack up 100 hours of non-clinical volunteering?

Giving of yourself to others is a form of empathy.

There are definitely sociopaths in medicine, so they can fake their way in. Luckily these people do seem to be in the tiny minority.

 

[MonkeyArrow]

Giving of yourself to others is a form of empathy.

Even if it is mandated?

 

[MDPedigree]

You cannot answer this question without knowing his MCAT score first. I wonder what he would get.

Any guesses and rationales for said guesses? This should be interesting....

 

[HopefulSlav]

Sociopathy is typically not a desirable trait among doctors.

 

[altblue]

Even if it is mandated?

I'd like to think it could potentially build empathy even when mandated, theres something about seeing and interacting with the very ill that speaks to you. Id hope a good chunk of the most selfish premeds won't get the volunteering or look at the extra requirements ("so much work") and drop it altogether

Of course one selfish girl with an ego and another girl I didn't care much for are both in med school, and they're at Mayo, so it doesn't always work, but generally I'd like to think it does

 

[altblue]

Sociopathy is typically not a desirable trait among doctors.

Yup, but it's not all bad. There's iBanking, consulting and big law for those folks, where they'll transfer around money with no purpose in their lives and still help those fields

 

[Goro]

Even if it is mandated?

If it helps weed out people who don't want to walk the walk, I'm all for it.

 

[dr_kateb]

I still don’t see how non-clinical volunteering demonstrates empathy? If clinical volunteering isn’t an unofficial requirement for med school I bet a lot of people wouldn’t do it. If you put non clinical volunteering in the same boat and say you need it, I don’t see it as any different as clinical volunteering or any pre-req course - it’s just another thing to do and check off.

 

[JMilo]

I still don’t see how non-clinical volunteering demonstrates empathy? If clinical volunteering isn’t an unofficial requirement for med school I bet a lot of people wouldn’t do it. If you put non clinical volunteering in the same boat and say you need it, I don’t see it as any different as clinical volunteering or any pre-req course - it’s just another thing to do and check off.

What others are saying is that if you lack empathy, you won't put in the effort in checking off the boxes even. Volunteering doesn't make you automatically empathetic, but having no volunteering definitely shows lack of altruism, or laziness, hence they are weeded out.

 

[dr_kateb]

What others are saying is that if you lack empathy, you won't put in the effort in checking off the boxes even. Volunteering doesn't make you automatically empathetic, but having no volunteering definitely shows lack of altruism, or laziness, hence they are weeded out.

I don’t think empathy is related to grit or a person’s ability to “bite the bullet.”

 

[JMilo]

I don’t think empathy is related to grit or a person’s ability to “bite the bullet.”

How would you judge empathy? How would you determine a person's commitment to the underserved, if not by volunteering to the underserved?

 

[dr_kateb]

How would you judge empathy? How would you determine a person's commitment to the underserved, if not by volunteering to the underserved?

That's my point. You really can't judge if someone is altruistic by his actions if those actions are part of some larger goal like medical school. Unless you make a guy watch sad videos and hook him to a machine that measures his emotional levels there really is no way to truly find out.

 

[Goro]

I still don’t see how non-clinical volunteering demonstrates empathy? If clinical volunteering isn’t an unofficial requirement for med school I bet a lot of people wouldn’t do it. If you put non clinical volunteering in the same boat and say you need it, I don’t see it as any different as clinical volunteering or any pre-req course - it’s just another thing to do and check off.

al·tru·ism
ˈaltro͞oˌizəm/
noun
noun: altruism

1. the belief in or practice of disinterested and selfless concern for the well-being of others.
   "some may choose to work with vulnerable elderly people out of altruism"

 

[Kurk]

al·tru·ism
ˈaltro͞oˌizəm/
noun
noun: altruism

1. the belief in or practice of disinterested and selfless concern for the well-being of others.
   "some may choose to work with vulnerable elderly people out of altruism"

So idealistic. If empathy is something that cannot be learned and you wish to accept only those applicants who have high levels of it that's fine by me. Just don't go around spewing the lie: "In America you can become whatever you want!".

 

[Goro]

So idealistic. If empathy is something that cannot be learned and you wish to accept only those applicants who have high levels of it that's fine by me. Just don't go around spewing the lie: "In America you can become whatever you want!".[/QUOTE]
And this has what to do with the OP, which was, after all, back in television-land?

 

[Med Ed]

You really can't judge if someone is altruistic by his actions if those actions are part of some larger goal like medical school.

We can certainly hedge our bets. The applicant who volunteers over a long period of time, who writes about it convincingly in their personal statement, addresses it convincingly during interviews, and has other supportive elements of their application (e.g. LORs), would be pulling off quite a feat to fake such a level of altruism. A lot of applicants have to be held at gunpoint to do even four hours in a soup kitchen.

I personally don't expect every applicant to have a specific end goal when they decide to volunteer. Sometimes the experience opens and changes individuals who are willing to see and listen.

 

[Microbug]

So idealistic. If empathy is something that cannot be learned and you wish to accept only those applicants who have high levels of it that's fine by me. Just don't go around spewing the lie: "In America you can become whatever you want!".

It’s good to always keep a little idealism with you, makes you look at people in good faith and you’re happier at the end. Why so cynical, cheer up! (Also a believer of you want be whatever you want!)

 

[Prometheus123]

I think an assumption underlying these questions is that all people who haven't done much non-clinical community service are not altruistic. However, that assumption is privileged and culturally mediated. Some people don't have the time and money to volunteer that much. Not everyone is raised in the state of perpetual admissions prep that many middle and upper class American kids are steeped in nowadays. And some people serve in less obvious ways.

For instance, I don't remember either of my parents ever volunteering. However, when they graduated from law school, they could have made tons of money doing corporate law. My mother in particular could have worked at any firm in the city, as she graduated top in her class at a time when firms were actively recruiting women for the first time (i.e. she was a URM). Instead, they chose to set up their own (much less lucrative) practice serving elderly and mentally ill clients. I remember one time when I was a kid, my mother started playing back the phone messages and on one of them there was a guy yelling death threats. She looked shaken, but she told me everything was OK. She explained that that was one of their clients who had schizophrenia and he must have gone off his meds, but that he was normally a very sweet man and he really needed their help.

I'm not saying my parents are the second coming of Mother Theresa, but I think their story shows it's fallacious to assume that everyone who hasn't done much volunteering is not altruistic.

 

[JMilo]

I think an assumption underlying these questions is that all people who haven't done much non-clinical community service are not altruistic. However, that assumption is privileged and culturally mediated. Some people don't have the time and money to volunteer that much. Not everyone is raised in the state of perpetual admissions prep that many middle and upper class American kids are steeped in nowadays. And some people serve in less obvious ways.

For instance, I don't remember either of my parents ever volunteering. However, when they graduated from law school, they could have made tons of money doing corporate law. My mother in particular could have worked at any firm in the city, as she graduated top in her class at a time when firms were actively recruiting women for the first time (i.e. she was a URM). Instead, they chose to set up their own (much less lucrative) practice serving elderly and mentally ill clients. I remember one time when I was a kid, my mother started playing back the phone messages and on one of them there was a guy yelling death threats. She looked shaken, but she told me everything was OK. She explained that that was one of their clients who had schizophrenia and he must have gone off his meds, but that he was normally a very sweet man and he really needed their help.

I'm not saying my parents are the second coming of Mother Theresa, but I think their story shows it's fallacious to assume that everyone who hasn't done much volunteering is not altruistic.

I think knowing volunteering is required, and still not doing it shows lack of altruism. You don't need to be privileged to help those who are less fortunate than you. Not enough time to volunteer = not enough commitment. Volunteering doesn't cost any money, so not sure what you are getting at there.

 

[Goro]

As with anything, context matters. If I see an app from someone who is working two jobs, and going to school and still able to shadow, then that person gets cut some slack. In particular, non-trads, for one, get cut some slack in this regard.

But to think that ALL med school applicants will be working and we'll blithely ignore them does us Adcom members a disservice, and, in fact, telegraphs once again naiveté of the admissions process.

The example of your mom is not helping, because she chose to be professionally altruistic AFTER she became a lawyer. I don't have the luxury of seeing the future and knowing where you will end up in your career.

From the wise LizzyM: I am always reminded of a certain frequent poster of a few years ago. He was adamant about not volunteering as he did not want to give his services for free and he was busy and helping others was inconvenient. He matriculated to a medical school and lasted less than one year. He's now in school to become an accountant.

I think an assumption underlying these questions is that all people who haven't done much non-clinical community service are not altruistic. However, that assumption is privileged and culturally mediated. Some people don't have the time and money to volunteer that much. Not everyone is raised in the state of perpetual admissions prep that many middle and upper class American kids are steeped in nowadays. And some people serve in less obvious ways.

For instance, I don't remember either of my parents ever volunteering. However, when they graduated from law school, they could have made tons of money doing corporate law. My mother in particular could have worked at any firm in the city, as she graduated top in her class at a time when firms were actively recruiting women for the first time (i.e. she was a URM). Instead, they chose to set up their own (much less lucrative) practice serving elderly and mentally ill clients. I remember one time when I was a kid, my mother started playing back the phone messages and on one of them there was a guy yelling death threats. She looked shaken, but she told me everything was OK. She explained that that was one of their clients who had schizophrenia and he must have gone off his meds, but that he was normally a very sweet man and he really needed their help.

I'm not saying my parents are the second coming of Mother Theresa, but I think their story shows it's fallacious to assume that everyone who hasn't done much volunteering is not altruistic.

 

[oralcare123]

Do you think House would've been able to get into med school in 2017 with his personality?

Is it ethical to deny someone who's so effective at diagnosing problems (moreso than their colleagues) just because of their personality?

I would 10/10 prefer House to be my personal physician over the "nice" person who's not as smart.

What do you think?

First of all, he wasn’t like that when he applied.
Second, everyone is able to act

 

[Prometheus123]

For the record, I currently am doing non-clinical volunteering. I wasn't talking about myself. I was just trying to point out what I still think is a privileged assumption in some previous questions. I may have more to say later, but for now, I've got to go because I'm on service in an hour.

 

[Kurk]

I wonder if medical schools in other non-western countries have the luxury of being so "particular" about their applicants; especially denying high numbers over altruism.

Also what does it mean if I'm currently volunteering in EMS; absolutely hate the job, interacting with the patients, the lack of pay for the liability, etc; but am genuinely praised by my colleagues for being good at what I do plus more???

 

[Prometheus123]

@JMilo, I was referring to the opportunity costs of volunteering. I currently volunteer about 16 hours a week across three different commitments. If I spent that time working instead, life would be easier.

@Goro, I know you guys look at the context and use your judgment. I'm just saying I disagree with the assumption that seems to be underlying a few posters' questions that everyone who doesn't volunteer is not altruistic by definition. Some of the kindest and most altruistic people I know do not volunteer in any reportable way.

That being said, I appreciate that the process encourages us to non-clinically volunteer because I can't think of a better way to reliably select for service-oriented and culturally-competent applicants. Personally, I've taken the encouragement I received from you as an opportunity to start doing something fun and challenging that I've wanted to do for a while now anyway. But for others who don't choose to do so, I humbly suggest interpreting their choice as a lack of evidence about whether they're altruistic or not, not as evidence that they're not altruistic, if that makes any sense.

 

[Goro]

@JMilo, I was referring to the opportunity costs of volunteering. I currently volunteer about 16 hours a week across three different commitments. If I spent that time working instead, life would be easier.

@Goro, I know you guys look at the context and use your judgment. I'm just saying I disagree with the assumption that seems to be underlying a few posters' questions that everyone who doesn't volunteer is not altruistic by definition. Some of the kindest and most altruistic people I know do not volunteer in any reportable way.

That being said, I appreciate that the process encourages us to non-clinically volunteer because I can't think of a better way to reliably select for service-oriented and culturally-competent applicants. Personally, I've taken the encouragement I received from you as an opportunity to start doing something fun and challenging that I've wanted to do for a while now anyway. But for others who don't choose to do so, I humbly suggest interpreting their choice as a lack of evidence about whether they're altruistic or not, not as evidence that they're not altruistic, if that makes any sense.

Jeeze, Promy, I think even a Tennessee mountain man would have been able to figure out that we were discussing applicants to med school, not the general public.

 

[Prometheus123]

Haha, we Tennessee mountain men are a bit slow. 😛

I will add though that the main person I'm thinking of when I say that is a physician (though she was never a US applicant). This person is truly a remarkably kind, compassionate, and altruistic person. I don't believe she's ever volunteered in a reportable way. Just sayin'.

 

[Robin-jay]

Jeeze, Promy, I think even a Tennessee mountain man would have been able to figure out that we were discussing applicants to med school, not the general public.

I know a bunch of the general public who go through a tough time in a hospital, shelter, etc. and then say "When I'm back on my feet, I'm going to help people who were in my situation too", and then proceed to never volunteer for anything after they're back on their feet lol.

 

[Robin-jay]

If someone stabs me in the chest and you roll me into the hospital and its 50/50 I will live or die, please, for the love of god, give me the dickhead who got a 4.0 and a 523 and who coughed up just enough charisma to get past these creepy first dates I mean med school interviews.

Meh. If there was more of a correlation between being a good doctor and GPA/MCAT, I'd agree.

That GPA and MCAT only proves that doctor is very likely to do well in medical school (grades and tests), not that they'll be an adequate physician.

 

[Robin-jay]

Its a much better marker for conscientiousness than this "did we like his tie. ooh he's kind of fat. oh she's from the correct race. that guy was rude in the lunch line. what are your favorite hobbies. (covertly) damn that girl is hot, I bet she'll make a great doctor" bollox

I do not care how nice my doctor is, I care whether or not he can help me to get better.

Agree 100%

My point was that GPA and MCAT aren't tremendous predictors on that. GPA and MCAT are good at predicting success with rigorous academic schedules, not how great your physician will be.

 

[Prometheus123]

Sorry for the tangent, but speaking of humanistic domains, JAMA has another great editorial about moral leadership in medicine that's very rallying and challenging. Here's the conclusion: "To try to avoid the political fray through silence is impossible, because silence is now political. Either engage, or assist the harm. There is no third choice."

 

[neoexile]

I do not care how nice my doctor is, I care whether or not he can help me to get better.

Step scores, general competence, whatever, I don't care how nicey-nice my doctor is, I care whether he can fix me or not.

Sorry, but i hate this logic. This implies that higher scores on tests translate into better patient care. It's often been shown that good interpersonal skills actually does and test scores aren't as great of a predictor of whether a doctor can bestow good outcomes or not.

Sorry, but I would rather have a doctor who isn't arrogant and knows hows to be humble over a doctor that thinks he's better than me because of some number on a test.

 

[neoexile]

Interpersonal skills don't have anything to do with how well my doctor can perform heart surgery or remove an appendix.

I agree that interpersonal skills will predict how well patients review physicians in most specialties.

Neither do Step scores or GPA. Those are faulty metrics to use in order to evaluate how good of a doctor you'll have. I know plenty of docs that didn't have the highest scores and can do both of those procedures well.

Generally, from what I know, the best doctors are the ones that are "teachable". And usually, this means a good attitude no matter what your "stats" are.

In fact, I worry about doctors that have little empathy but still know a lot. Usually, this means extra procedures which are unnecessary and can sometimes be permanently damaging to the patient like a back surgery done for no reason. (Yes this has happened).

 

[Kurk]

People who think differently and independently of others are sometimes more likely to be the Dr. House type. That mentality sometimes translates to being an dingus/jerk . Again, if I have a gunshot wound, give me the star diagnostician or OCPD surgeon.

Even if I'm in an office setting, I hate it when healthcare professionals talk to me in their fake "nicey nicey" tone as if I were some naive child. It annoys me to a great extent. Sometimes I wish that Dr House would walk in and crack a joke. Hell, I'll even take Dr. Hartman from Family Guy (well, not really).

 

[longhaul3]

So, when you and I both get sent to the ER with gunshot wounds, you get the nicey-nice URM with a 498 and I'll take the Asian with the 523 who didn't shower before his interview. Deal?

Need for achievement is a reasonably durable feature of character. Conscientiousness is very durable.

How and why we started sorting physicians by agreeableness...is beyond me, except to coddle the very profitable groups of mild hypochondriacs and patients presenting for illnesses that are predictable consequences of volitional behavior.

Many gunshot wounds are "predictable consequences of volitional behavior."

You'll see when you get to medical school that those scores go out the window. The vast majority of med students succeed. Do you choose your doctors based on where they went to college?

 

[begoood95]

Sorry for the tangent, but speaking of humanistic domains, JAMA has another great editorial about moral leadership in medicine that's very rallying and challenging. Here's the conclusion: "To try to avoid the political fray through silence is impossible, because silence is now political. Either engage, or assist the harm. There is no third choice."

Great article, thanks for the share!

 

[Prometheus123]

Great article, thanks for the share!

You're welcome, I'm glad you liked it! 🙂

 

[mistafab]

Chiming in.

Did not read the thread. However - to answer main question - yes.

 

[neoexile]

So, when you and I both get sent to the ER with gunshot wounds, you get the nicey-nice URM with a 498 and I'll take the Asian with the 523 who didn't shower before his interview. Deal?

Need for achievement is a reasonably durable feature of character. Conscientiousness is very durable.

How and why we started sorting physicians by agreeableness...is beyond me, except to coddle the very profitable groups of mild hypochondriacs and patients presenting for illnesses that are predictable consequences of volitional behavior.

Okay great. So by your logic, you'd have this surgeon treat your child:

A CNN investigation, a closed heart surgery program, a resigned CEO: What happened at St. Mary's Medical Center?

The surgeon in question was educated at the pediatric cardiothoracic surgery program at Stanford University. However, the mortality rates of his patients were much higher than the national average. The reason?

It was because he did not respond to the board's feedback for higher volume and did not correct accordingly. He instead kept giving false reassurance to families that their children would be in the hospital in a day (or 2 days for complicated patients). This is why I say: ATTITUDE MATTERS! Stats on some tests do not define how well you will do as a physician. Your ATTITUDE does!

Yes, if the 498 URM is well respected by his or her peers and knows how to deal with gunshot wounds and shows a consistently high metric in both patient satisfaction or low complications, I'll take the URM plz.

 

[non-trad++]

I agree it probably can't be learned from the ground up. I don't think that a psychopath could learn empathy, for instance. And that definitely makes sense that you'd want applicants who already have that trait well developed before entering med school. But I think most people have all the basic building blocks for empathy (mirror neurons, the ability to generate theory of mind), and we strengthen a neural network whenever we use it (neuroplasticity). So, I'd argue that most people can probably at least incrementally improve their ability to empathize with practice. I'd also argue that suffering and experience with suffering populations improves one's ability to empathize.

I wish I could’ve been this eloquent in my answers to an interview question about “which doc trait is most important?” for which I answered Empathy. I agree with the above as well as with @Goro. In my answer I said Empathy cannot be acquired - you either have it or you don’t. Empathy is a result of having [similar] past experiences (been there done that) and having a Big Heart!

EDIT: On second thought, it can be acquired... as you gain life experiences... but, the main prerequisite still remains: you must have a Big Heart!
Sorry, I forgot about the ‘kids’ in here that are still gaining the said experiences. My bad.

 

[Prometheus123]

I wish I could’ve been this eloquent in my answers to an interview question about “which doc trait is most important?” for which I answered Empathy. I agree with the above as well as with @Goro. In my answer I said Empathy cannot be acquired - you either have it or you don’t. Empathy is a result of having [similar] past experiences (been there done that) and having a Big Heart!

Thanks. I wish I could have been skillful enough to get an interview this cycle. Hopefully we'll all get where we need to go soon enough. 🙂

 

[ekmf27050]

I personally did the whole "searching out the most skilled surgeon for my case regardless of personality" thing

And let me tell you, it was painful. It's one thing to say abstractly that you want the best surgeon and don't care if they're sociable, but holy crap, it would be nice to have both. The technical part of my surgery went off without a hitch (much as I expected). But the uncomfortable-ness of trying to communicate with the surgeon during pre-op and post-op was terrible. I also had post-op complications related to anesthesia, and found it disturbing that no one from the surgeon's team checked in with me before, during, or after my decline, ER trip, and hospital stay- my PCP had to take that on.

I recently had another surgery where the surgeon was technically skilled AND had good communication skills, and I was literally blown away. He called me, twice, himself, to check in after surgery. We talked for maybe 5 mins, but the fact that he was making an effort really stood out to me in contrast to my first surgeon.

TL;DR --- while searching out brilliant sociopaths for your health problems seems good in theory, it is horrible to experience as a patient. It may be touchy-feely to want someone who treats you like a human being, but someone being wrist-deep in your body is, by definition, both touchy and feely

 

[Kurk]

I personally did the whole "searching out the most skilled surgeon for my case regardless of personality" thing

And let me tell you, it was painful. It's one thing to say abstractly that you want the best surgeon and don't care if they're sociable, but holy crap, it would be nice to have both. The technical part of my surgery went off without a hitch (much as I expected). But the uncomfortable-ness of trying to communicate with the surgeon during pre-op and post-op was terrible. I also had post-op complications related to anesthesia, and found it disturbing that no one from the surgeon's team checked in with me before, during, or after my decline, ER trip, and hospital stay- my PCP had to take that on.

I recently had another surgery where the surgeon was technically skilled AND had good communication skills, and I was literally blown away. He called me, twice, himself, to check in after surgery. We talked for maybe 5 mins, but the fact that he was making an effort really stood out to me in contrast to my first surgeon.

TL;DR --- while searching out brilliant sociopaths for your health problems seems good in theory, it is horrible to experience as a patient. It may be touchy-feely to want someone who treats you like a human being, but someone being wrist-deep in your body is, by definition, both touchy and feely

I was actually pretty annoyed when my oral surgeon called me after my procedure. When I'm in a position of weakness (surgery), I'd prefer that a robot was doing it. Unfortunately we're not there yet, so an asocial surgeon is the next best thing.

 

[calivianya]

I don't know if this hasn't been brought up - sorry, haven't read the whole thread.

The biggest problem with Dr. House is in real life, I can't see patients taking his advice. Sure, he's a skilled clinician... but people are stubborn, and I've seen over and over again where people did not follow what their physicians told them to do because they didn't like their physicians' attitudes. I've seen families fire our most experienced, very skilled intensivist because they didn't like what he told them about their loved ones' prognosis. They ended up with someone who'd only been out of fellowship for a year, who knows a lot less, but whom they liked much better because of his attitude.

Maybe we'd all pick competence over attitude on here because we know better, but the general population are idiots and will listen the nicest physician every time, regardless of competence. Unfortunately, those are the people we have to convince to take care of themselves so they can stay out of the hospital and quit driving our healthcare costs up, so we need to graduate more people that they will listen to.

 

[Kurk]

I don't know if this hasn't been brought up - sorry, haven't read the whole thread.

The biggest problem with Dr. House is in real life, I can't see patients taking his advice. Sure, he's a skilled clinician... but people are stubborn, and I've seen over and over again where people did not follow what their physicians told them to do because they didn't like their physicians' attitudes. I've seen families fire our most experienced, very skilled intensivist because they didn't like what he told them about their loved ones' prognosis. They ended up with someone who'd only been out of fellowship for a year, who knows a lot less, but whom they liked much better because of his attitude.

Maybe we'd all pick competence over attitude on here because we know better, but the general population are idiots and will listen the nicest physician every time, regardless of competence. Unfortunately, those are the people we have to convince to take care of themselves so they can stay out of the hospital and quit driving our healthcare costs up, so we need to graduate more people that they will listen to.

Sounds like a great manipulation tactic.