Reforming Medical Education

Medical school, residency and specialty fellowship cannot prepare physicians for every eventuality.  Many important skills must be acquired on the job.  And, of course, physicians need to remain current with respect to cognitive and procedural advancements.  Here are just few critical subjects that I was not prepared for when I entered the healing profession.

What happened to my phone medicine lectures?

• Phone medicine.  Treating a patient with abdominal pain at night on the phone requires different skills than when the patient is in my exam room. And, te phone call may be the first time I have ever spoken to this patient.
• Breaking bad news to patients and their families.  Wouldn’t you think that we would have received training for such a critical skill?
• Nutrition.  Patients are understandably amazed at my paucity of nutritional knowledge.  I suspect that most gastroenterologists can make the same claim.  Wouldn't you think that nutrition science would be part of a gastroenterologist's skill set?
• Leadership skills   I have done my best in 30 years to treat my staff well, earn their loyalty, reward their performance and to set an example.  I hope I have done well in this regard, but I have had no formal instruction in this discipline.
• Attracting patient referrals from potential referring physicians.   Might this important to a medical practice?
• Caring for difficult and demanding patients.  It’s easy to treat cooperative and appreciative patients.   But, caring for patients who are angry or entitled requires special skills.  Shouldn’t these be taught?

And, we never received any training in the business aspects of the profession.  I was in private practice for 20 years, although I am currently a happily employed physician.  As a private business owner,  I had to grapple with overhead, payroll, medical coverage and retirement benefits for my staff, landlord issues, tax and accounting issues, scope purchases and repair, physician referral patterns to the practice,  cash flow, our competition and office personnel issues..   How much training in these skills do you readers think I have had?  Let me enlighten you. Zero!   I was smart enough, however, to know how ill equipped I was so we hired real professionals to make it all work smoothly.

Perhaps, medical educators should have a word with us grunts in the field to find out what was omitted in our training.