"The good doctor" article in JAMA

[Siverhideo1985]

Very interesting perspective on humanism in medicine and the importance of, and barriers to, holding on to the empathetic approach that a lot of us enter medical school with. Agree that there is often something that gets lost between the last two years of medical school and residency; so many residents I've worked with have already lost their humanistic approach (largely for the sake of efficiency it seems) to medicine and their patients. Anyways...just an article that I thought was worth reading (esp for med students) with a unique perspective.

"He told me to focus on my ability to connect with people. The medicine would come in its time, but humanism lost could not be recouped so easily. 'By the time they're residents,' referring to the trainees he works with. ' we can't teach them that. It's too late. ' So now, as medical students, it is the right time. We must teach ourselves, and each other, that in the process of gaining medical knowledge, a capacity to engage humbly with human suffering cannot be sacrificed"

- Shekinah Elmore, MPH
JAMA, October 12th, 2011 Issue

I'm sure you'll be able to get your hands on the full article through your institution, if interested. Something to think about at least.

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[Narmerguy]

I liked it

 

[cellsaver]

...."By the time they're residents,' referring to the trainees he works with. ' we can't teach them that. It's too late. ' .....

OP, I noticed you are still active on SDN as of July 2017. Thanks for the JAMA quote.

I have had Attendings at my school tell me exactly what you quoted from JAMA. Many don't even try to cajole Residents to "show up" for their patients and medical staff because of the reasons stated in the JAMA article.

Given that it is 2017 and "connecting with people" has morphed into online, texting, "social media", a dearth of well honed interpersonal skills and avoiding face to face encounters at all costs, I wonder how you see the situation 6 years later. How do you live it as an MD/MPH with your patients?

thanks

 

[JP2740]

OP, I noticed you are still active on SDN as of July 2017. Thanks for the JAMA quote.

I have had Attendings at my school tell me exactly what you quoted from JAMA. Many don't even try to cajole Residents to "show up" for their patients and medical staff because of the reasons stated in the JAMA article.

Given that it is 2017 and "connecting with people" has morphed into online, texting, "social media", a dearth of well honed interpersonal skills and avoiding face to face encounters at all costs, I wonder how you see the situation 6 years later. How do you live it as an MD/MPH with your patients?

thanks

The thread is from 2011

 

[Crayola227]

oldie but a goodie

 

[WheezyBaby]

The thread is from 2011

Pretty sure he recognizes that based on his post

 

[ACSurgeon]

Part of the problem is that the professionalism/humanism isn't taught in med school (i.e. via reasonable curricula and good role models). Rather, it is exaggerated and forced. So, as soon as students get out to the real world of clinical medicine, they quickly start to behave like their seniors.

Also, there's a certain degree of beating on trainees that makes the process more about surviving, pleasing your superior etc rather than enjoying the human aspect of taking care of patients.

Other aspects make medicine less personal and more about getting the job done: admin, EMR/billing rules/etc.

Finally, if you maintain the same level of naive humanism, you'll burn out. If you lose it all, the job won't be worth while.

I think most of us maintain an ok enough level. Just my 2 cents.

 

[WheezyBaby]

I was a very preferentially soft science person prior to med school, almost turned down med school acceptance to pursue clinical psychology. I identified as deeply humanistic at that time of starting school, and I think probably kept it going to a reasonable degree, though certainly not to the same degree, for most of my time as a student. At some point over intern year my strong humanistic values transitioned into focusing my efforts at being the strongest clinician I could to "diagnosis manage and dispo chf/cirrhotic/etoh withdrawal patient #2347". The constraints of medicine make continuing to really connect with the patient difficult, but it's certainly not impossible. Trying to refocus myself on that now. I like lazymed's post, but I'm not sure I agree with the last point. Decreasing your humanism is certainly one way to cope with the career, but I don't think it's the only way; it certainly doesn't seem to be for my pediatric palliative colleagues anyway. Can't say I have it figured out though

 

[sliceofbread136]

Honestly with inpatients I don't see a whole lot of value in forming a super strong connection since it will likely be short term. What I feel is important is that you make it clear that you are there for them and that if they have concerns or needs that aren't being addressed that you will help them to the best of your ability. Also have to be cognizant of social issues that need to be addressed.

Long term outpatient relationships on the other hand I think require more of an actual relationship to be formed

 

[USCguy]

Go to a patient's funeral. Connecting with a family after a death is refreshing in a weird way and reminds you of the human side outside the hospital/clinic walls.