I agree with most of what you say. My only problem with ?lounge rounds? is that all too often it stops right there ? there is no real bedside teaching.
I think this mirrors a trend in our medical education where the clinical method has been entirely sunk undersea. Fewer and fewer students get good training in taking a good history and doing a good exam. This is reflected in their increasingly poor performance ? 3rd year residents perform no better than 4th yr med students in cardiac ausculatation, recognising only 20% of abnormalities. The figure is 40% for lung sounds. There is a general ineptitude in learning to think about a clinical problem ? I have lost count of the number of students whose first reaction to mental status changes in a patient is ?let?s get a head CT?. WTF??? You wouldn?t believe the number of fourth year students I?ve had rotating through neurosurg who cannot do a half-way decent neuro exam, and I find myself having to teach them this ? they look as if they?re seeing it for the first time.
I think part of the problem is that increasingly the people who should know better, the people who should care, the people whose responsibility it is too teach us to become good doctors, don?t bother anymore. The professors themselves just scan everyone these days, order unnecessary tests. Bad habits are easy to pick up, and when students see this, they just incorporate it into their general approach to medicine.
Sorry to the OP for the digression. Pet peeve. 🙂
