What are Doctors Learning Anyway?
For patients, doctors, and other medical practitioners, are almost God-like. We see them as paragons of medical knowledge. Why? Because they went to medical school. Patients trust medical schools to educate doctors effectively. That begs an interesting question: what exactly are they learning?
Apparently, not everything they need.
Medical schools provide a great technical education in medicine. For example, your doctor can tell you about all kinds of different cancers. But what many do not provide is a great education in doctoring. Being a doctor is about more than the science, it is a role that requires social skills as well.
A report from the National Patient Safety Foundation argues that “Because of the current lack of emphasis on patient safety education and training, today’s medical schools are producing square pegs for our care system’s round holes.” That is not to say that doctors have not come a long way since the Hippocrates, but it is not perfect. There are between 44,000 and 98,000 preventable deaths each year. One study reported that 70% of inadvertent patient harm was the result of poor communication.
As the population ages and patients develop multiple conditions that require specialized care, team driven medicine will be extremely important to keep care coordinated across multiple doctors. But medical schools do not emphasize the development of proper communication and teamwork skills. Without them, adverse effects from “hand-offs” between doctors are more likely.
The other crux of this reform effort involves developing a process of continual education throughout the residency process. Called the “hidden curriculum,” residents end up emulating the actions of theirresidency mentors . Unfortunately, some witness, and later adopt, unprofessional behaviors.
According to the NPSF report; “Ninety-eight percent of students had heard physicians refer derogatorily to patients; 61% had witnessed what they believed to be unethical behavior …54% felt like accomplices. ... 62% believed that at least some of their ethical principles had been eroded or lost.” By incorporating a classroom-like process concurrently with these experiences, students will develop a sense of professionalism and a patient-centered outlook. Furthermore, by better educating future doctors, we can break the cycle.
In Minnesota, we are lucky that the Mayo Clinic and the University of Minnesota's medical schools have begun to institute many of these reforms. Policy makers could hurry the process along by requiring that schools show progress toward these goals as a condition of receiving financial support. The threat of a financial sanction might be enough to drive many schools to revamp their curricula. These reforms are likely to help keep costs down, improve patient health, and give us better equipped medical practitioners.