Does your doctor see you, or your disease?

At 11 a.m. today, the Daily Circuit will examine the effort some medical schools and clinics are making to transform the traditional third year of study. That’s when students often experience a dehumanizing regimen of rotation and overwork.

A blog post in the New York Times offers one doctor’s observation of the third year’s effect on a colleague:

The third-year schedule of rotating every few weeks among teams of doctors, trainees and real patients had left him gaunt. He showed me a stack of index cards, one for each patient he had been assigned in the last week.

“I got an ‘appy,’ a gallbladder and a breast biopsy,” he said, referring to patients with appendicitis, a gallbladder infection and breast cancer. He pulled out one card highlighted in yellow and smiled. “I also got a Whipple,” he said, referring to a patient with pancreatic cancer who needed that potentially complicated surgery. “That,” he continued without flinching, “was awesome.”

My friend wasn’t the same. The patients had been reduced to their diseases.

Kerri and her guests will discuss a new approach that aims to restructure the third year in a way that allows medical students and their patients to develop lasting relationships — in other words, to help students work on people skills as well as technical skills.

What’s been your experience? Have your doctors tended to treat you as a patient, or as a disease?

  • Dan Smith

    The same kind of hand wringing about objectifying patients went on 34 years ago when I entered medical school. What it fails to credit is that the need for doctors to make decisions that aren’t based on emotions trumps the touchy-feely sensibilities of social scientists. Caring for patients requires suspension of ordinary human rules for interaction. As your doctor, I may need to perform painful procedures on you or a loved one; I may have to deliver unwelcome news; I may have to watch as you suffer and die. I don’t want my doctor not to do what he needs to because of a re-ordering of priorities, and unfortunately that is what efforts to “humanize” medical care are leading towards.

  • Dan Malkovich

    38 years ago I went to Granite Falls, MN, as a third year medical student in the RPAP program. That year was one of the best of my life. For the first time I felt as though I might have a life after medical school. Since childhood, I had been in love with the idea of family practice–getting to know my patients within the context of their families and community while administering to their medical problems. The daily grind of medical school, however, filled as it seemed with confrontation and criticism, had come as a shock. But the mentors I encountered in Granite Falls guided me with encouragement and patience while demonstrating standards of excellence and compassion in their professional lives. I felt accepted, even valued, within the community.

  • Kim

    My Dr. definitely sees me. He is anfamily Doc who has his extra training in osteopathy. He know about what,s going on at home, makes sure he is kept up to date on things that may effect my well being as to meds I am on. He is very open to alternatives to drugs if it’s something that is fairly proven. I also take my elderly mother (whom is living with me) to this same Dr. He had made one wrong judgement in thinking mom MAY be experiencing a stomach aneurysm. Sent us to ER. She received several tests and this proved to be something different. Point is that he felt that this shpuld be ruled out and rather than GUESS, he sent us in the right direction. This man has called me personally to give advice and has come out to parking lot to hand me a prescription. Sure he treats all of his patients with this same respect. My mom and I are feel very appreciative that we were given the awareness that he would be a good physician, fit for both our med issues and the 2 way respect that we did not feel we were getting previously.