- On page 71, Good inserts a quick note about how the education of a French physician differed from that of an American in that the first two years in France focus on semiology while those in the U.S. focus on the basic biomedical sciences. The point gets no further discussion besides this one mention, indicating perhaps that the author deems it important enough to include but not to discuss. Do you think that this difference should be viewed so nonchalantly? How might this difference in curriculum affect the mindset of the physician in diagnoses, patient interactions, or general outlook on the purpose of medicine?
- Throughout the piece, Good argues that students are learning to construct an entirely new world as they work their way through medical school. One of the many pieces of this new world with which they must become acquainted is, for example, the language of medicine. What would happen if one of these pieces were not incorporated into the “lifeworld of medicine”? Could the medical world exist if any one of its developed attributes, like language or the experiences had in anatomy lab, were removed? If it could, how would the loss of the attribute affect it?
- A third year student reflects on the development of his patient write-up skills, noting that he eventually came to interact with his patients with their write-up constantly in mind. If a physician considers his patient only in terms of what needs to be known about them medically, does the patient lose their identity as a holistic human being?
- Good brings up the Patient-Doctor course of Harvard’s Pathway curriculum in response to concerns that there are relatively few chances for medical students to learn more about medicine in the context of society and ethics. Given all of the information with which they are being inundated about the biomedical aspects of the body and how to care for these, is there enough brainpower left to devote to studying doctor-patient interactions in medical school itself? Is there a time or place where it would be more effective to discuss these issues?
Wednesday, September 2, 2015
Discussion Questions: How medicine constructs its objects
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In response to your third and fourth discussion questions, I think the importance of the doctor-patient relationship is often underestimated, or even neglected completely. Often it is too easy for doctors to see patients as their diagnosis instead of as a person because of the way our culture constructs medical practice. The goal of modern medicine is more focused on squeezing in as many patients as possible than focusing on the patient in front of you and helping them get better or stay healthy. Many doctors don’t know how to properly interact with a patient and have terrible bedside manner. I think it is very important to somehow incorporate a time to learn about doctor-patient interactions during medical school.
ReplyDeleteI recently read this article (link below) about how Wash U medical school pays actors to come in to be standardized patients for the medical students to practice doctor-patient interactions with. I think this addition to the medical curriculum to a fantastic idea because it helps students practice empathy and caring for patients as individuals. It gives them a chance to practice their diagnostic skills and abilities, while also learning how to interact with the patient and share those diagnoses. It’s a good practice space so that no medical student goes into a room with a “real” patient and blurts out “You’ve got cancer” like one of the practicing students did with a standardized patient. I hope a program like these gets implemented into all medical schools, because I think this hands-on instruction prior to the clinical part of medical school is great practice both for diagnostic skills and empathy skills.
http://outlook.wustl.edu/2014/apr/standardized-patients