This conversation is closed. Start a new conversation
or join one »
What if medical schools cultivated the art of healing along with knowledge acquisition.
By the time a person actually becomes a doctor they've been stunted by spending years on the backbreaking labor of knowledge acquisition. Not only does this activity break the connection to one's "small little voice in the head" that might save the patients life, but it makes a person a slave to knowledge that is quickly outdated. Doctors can be myopic and closed to new information precisely because medical education is overwhelming biased toward studying; it leaves new doctors wildly unprepared to listen and heal.
Rhona Pavis 50+
Kathy Merrell
Denise Bem David 50+
I have quite a different experience. During and after the Medical School we were constantly reminded that we were treating patients, not diseases, and that the patient care is the goal. I participated in groups to discuss medico-patient interaction during years. We knew that a clear communication between the MD and the patient is vital for the treatment. Otherwise you prescribe medication and the patient does not take it, for instance.
I was never warned against my inner voice during my training, just that intuition should be backed by study, sound medical evidence, and experience. When I was worried with a patient that looked fine but made me feel somehow uneasy, I kept on paying attention, examining and caring very closely, and discussing with other colleagues the case. I learned that anxious, demanding patients can have concomitantly a serious clinical condition in parallel with the psychological condition, and both must be well cared for. Treat the cancer without dealing with the anxiety is bad, as is the other way round.
I would say that most doctors are open to new information, and are not intellectually myopic - even if a great number of us are physically myopic and use glasses ;-)!
It is not easy, and it is tiring to be a good doctor: long working hours, always studying, always putting patients first. Maybe the American system does not contribute to a culture of trust between the treating physician and the patient.
jeffrey friesen 20+
Kathy Merrell
Jeff Cable
I am not a clinician.
My background is that of a clinical nurse specialist and I have 35 years experience working for the NHS in the fields of trauma and orthopaedics. Having retired 10 years ago from the NHS, I now work for myself as an orthopaedic technician. I specialise in working with very young children with spinal deformities, hip diseases such as Perthes, CTEV (congenital talipes equino-varus) and Ilizarov frames; post leg-lengthening surgery.
My work is primarily the bread and butter work of fractures secondary to trauma. My specialist work includes NICU, PICU, ICU, (all intensive care units) Theatre (OR) and A&E (ER). The quality of my delivered care is extremely important to me and I do what I can to ensure that the needs of the patient are the only consideration with which I legitimately concern myself.
jeffrey friesen 20+
Jeff Cable
in my experience of acupuncture, I have seen many clinicians who have attended a weekend course in acupuncture and at the end of it they were presented with a certificate and a set of needles. These people are not acupuncture practitioners and what is more, they never could be with such a short induction to a healing art that requires many years of study.
I have worked with British anaesthetists who had studied acupuncture for 5 years in China. On their return to the UK they were comfortable with allowing major surgery to take place under an acupuncture neural block. The patients remained conscious throughout the surgical procedure and as a result the procedures were considerably safer because all anaesthesia is a calculated risk.
Back on point: It is the lack of appropriate documentation from practitioners of a particular therapy that cause it to be largely ignored by conventional medicine. The notion of accepting the word of a non-medically trained person as a valid rationale for initiating a particular treatment, is very unlikely to fly, especially where the treatment has little effect or even unintended consequences.
No clinician, in their right mind, will initiate an untested treatment for a patient because it is a gross dereliction of the duty of care inherent in the patient/doctor relationship. In a litigious society such as that which is found in the USA, a medical doctor would not be practising for long if they were easily encouraged to ignore the work of their prudent colleagues, in favour of snake oil.
I don't mean that all therapies which are alternative or non-mainstream are merely snake oil but it is clearly undesirable medical practice until proven to be useful.
Mary M. 100+
What a wonderful idea/conversation. I have been dealing with alot of doctors lately. Sometimes when I walk out of the office I am so downhearted and feel like I wasn't really heard. I was just a number and not a human being. What is sadder is that my parents are the ones that are the patients.
Sadly, it is an epidemic.....BUT, I will give you a little hope. We have one exception in our city. The ophtomologist that sees my dad, also is an avid TED viewer. He is so kind and gentle with his ways. He is young, and very much on top of all the latest information. I know, because I started sharing with him some of the TED MED talks I've viewed, and he ellaborated on the technical information that the speakers did not mention.
It did my heart good knowing that such doctors still exist.
Your know Kathy, I once ran across a quote about teaching, that can easily be applied to doctors. Just substitute the words teaching, for medicine/doctor care.
"Good teaching cannot be reduced to a technique. Good teaching comes from the identity and integrity of the teacher"
Training is good, but what it all comes down to is the integrity of the doctor. It involves his core values, why he became a doctor, and how he views life, any life, not just his paying patients.
Anyways, a while back I ran across this wonderful talk by the US Surgeon general. One minute into the video, she explains how she stood up for something she thought needed changing in medical school. You sound sort of like her. Maybe watching this wonderful video will inspire to do something great for your colleagues in the medical field.
Why, you may even wish to notify her and get her backing for your idea.....Why not? Go for it Kathy!!!!!!
http://youtu.be/MyN0GjRwYyw
Be Well :)
Fritzie Reisner 100+
From my experience, I would have hypothesized that the integration of alternative ways and styles of looking at healing/medicine is becoming more rather than less common even within established health settings. I don't know this to be true, but it would be consistent with my limited experience.
Kathy Merrell
Jeff Cable
A search for a simple fracture of the scaphoid bone (essential to wrist function and grip) and internal fixation treatments discovers 561 research articles on PubMed alone. Reading these articles may not point to a counsel of perfection but it provides a starting point for anyone who needs to find out something about the injury and the potential sequelae of internal fixation.
Medical practice advances by this generally agreed means. Integrative and alternative therapies may work but their application is frequently a 'seat of the pants' usage that is not reproducible easily by other people; who may wish to know more about the skills and techniques required to use a novel method of treatment.
Medical research is peer-reviewed and others can reproduce and refine the findings of any particular treatment. Where the observer detects a mistake in method application, all previous papers are used as a guide to refine the treatment. Careful documentation of any method is open to deep scrutiny (globally) and alternative and integrative therapies are not yet documented by people in any coherent way. Neither are the people who use a particular alternative therapeutic measure subject to a minimum standard of knowledge requirement.
Knowing when I don't know is the most important tool which I carry with me when treating acutely injured people with fractured bones.
Kathy Merrell
jamie abernathy
Linda Taylor 50+
http://www.pbli.org/pbl/medical_pbl.htm
jeffrey friesen 20+
And any doctors who don't realize this should stop inflicting their dysfunction on humanity.
on edit: Not all doctors stay stuck in that kind of training. They outgrown and out evolve it. It is a starting point, not an end point.
Linda Taylor 50+
I had the chance to tour Mayo's simulation lab. They have entire rooms set up and dedicated to this type of learning. Most medical schools even advertise this method of instruction.
jeffrey friesen 20+
I didn't check the link and transposed in my grey cells with another concept. Sorry about that. Age can be a mofo.
Having said that I would say that yes, PBL is taught in all medical schools, but an alarming number of doctors don't seem to be using it much post graduation. We see WAY too many patients who come to us after seeing another doc who is practicing recipe card medicine: they take the symptoms, mix them together and follow the recipe to find an answer and if it doesn't work, well, it must be because the patients wasn't compliant (or some other excuse).
I don't blame docs however. It is difficult, if one is mired in insurance based practices to move beyond the box the insurance company is willing to pay for without causing the doc to spend hours arguing with an uneducated no-think-em about necessary. After a while it just becomes easier to do what you know will be reimbursed, cash the check and walk away. Anything else is punished.
Linda Taylor 50+
Besides, the only person I have ever seen heal anything was the patient.
jeffrey friesen 20+
The problem as I see it in focusing that diagnostic process to disease management rather than patient management, that you tend to get systems analysis.
Pt:"Gee doc, I have symptom X, Y, and Z. What should I do?"
Doc: "I don't deal with X and Z, but here is a prescription for Y and a referral to Dr. A for symptom X and Dr. D for symptom Z.
The problem here is that too many physicians are not given the time nor tools to make those connections, and if we aren't going to have the doctors do that work, who do you suggest when you say that we shouldn't have the docs doing everything.
BTW - at our clinic our docs spend an average of 20 to 30 minutes with every pt follow-up appt. and sometimes over an hour with each new pt. intake. They get a thorough history and work up of subjective and objective data. By giving that time to the pt, they are able to miss fewer things and work up a functional understanding of that pts. case. There is a reason that we are where pts come when no one else is helping.
Again, I don't blame the docs who are mired in the insurance paradigm. FYI - we do not bill insurance (national average of insurance billing specialists to doctors, 3:1 - in Canada that ratio is 1:7 - yikes!!!) and as a result of lowering that significant amount of overhead and wasted medical specialist time, we are able to lower our costs to pts while still maintain a healthy profit margin to attract good docs.
The insurance (broken) system time is done. Let's stick a fork in it.
Could you explain your second last sentence more? I'm not sure what you are talking about.
Linda Taylor 50+
I agree 100% the insurance system is broken. It is troublesome that third party payors are more interested in stockholders than healthcare. I really think Obamacare is gonna tank the entire system. I have been posting against that for a long time. It is not about healthcare, its about insurance.
That said, many people are going around saying they are healers. Spiritual healers, alternative healers. The art of healing. The word is over used and over applied. The only person I have ever seen heal anything is the patient themselves. Wounds, illness, infection. I think we need to work with patients to help them heal with medicine, treatments, and surgery. But the person that heals is the patient.
Kathy Merrell
jeffrey friesen 20+
A friend of mine is a doc in Canada and he spends about 20 to 30 minutes with each patient. His nurse handles his entire days insurance billing in less than a half hour at the end of each day online. He works 35 hours per week and never deals with insurance dorks overriding him or not paying him. He knows a year ahead of time what his reimbursement rate is, and if that isn't good he and his professional organization is able to negotiate changes. Best of all he has plenty of time for CE and keeping up with journals.
Compare that to the USA where docs also see pts for about 35 hours per week and spend the rest of the time in paperwork, plus the also support some of the 3 insurance billing specialists employed for every doctor in the USA.
I do agree with Linda that the only people who heal are patients. At best docs help them on that journey.
Linda Taylor 50+
Doctor's treat disease and nurses treat people.
Kathy Merrell
Linda Taylor 50+
Comment deleted
Kathy Merrell
Comment deleted