Teaching the “Intangibles” of Medicine
An editorial on Healio.com highlights the importance of “intangibles” in medicine, primarily the connection between patient and provider. In the commentary, Leonard H. Calabrese, a rheumatologist and course director at the Cleveland Clinic Lerner College of Medicine, shares concern that empathy and mindfulness are pieces of medicine “we know very little about.” Consequently, he’s made these subjects a focus of his medical research and teaching.
Calabrese writes that while many assume the “patient-provider relationship is simply intuitive…recent analyses suggest this type of quality interaction can be viewed as a skill that can be learned and executed through teaching and modeling advanced communication skills.” The Stanford Medicine 25 initiative does exactly that. Our Stanford 25 physical exams, “5 Minute Bedside Moment,” annual skills symposium and more teach physicians how to engage with their patients. Similarly, programs like ACE at Johns Hopkins take the same approach and are advocating for and prioritizing bedside medicine as part of the medical school curriculum and residency training.
As co-chair of a recent summit for rheumatology fellows, Calabrese admits he had some hesitation in presenting on “communication skills,” but found the “group remained thoroughly engaged, and many commented…that topics such as ‘how to build relationships in clinical care’ and ‘how to buffer and build our empathy’ are long overdue in rheumatology training.” We observe this same eagerness among our residents. And a meaningful patient connection also has reciprocal benefits for physicians, such as increased confidence and a decrease in the risk of burnout.
We believe that promoting these benefits and the bedside medicine skills that support them could positively transform a system that’s currently pulling clinicians away from the bedside. A medical education and ongoing training on these two critical pieces of medicine – the “hard science” and the human relationship—can lead to what Calabrese describes as a type of success “that occurs when health care providers and patients truly connect.”
Humility is an underappreciated skill in a time of global budgets, evidenced based approaches, and cost-containment. The bright, well-read, talented medical students who may lack humility are not uncommon.
Patient-centered care is an important aspect of the National Strategy for Quality Improvement on Health Care. As such, healthcare institutions are strongly focusing on the patient-physician relationship and the patient experience.
The editor-in-chief of Medscape, Dr. Eric Topol, visited Stanford to sit down and do an interview with our Dr. Vergese for the Medscape One-on-One online video series.
Peter Conrad, a sociologist at Brandeis University, spoke of the rise and fall of the medical authority in the doctor patient office encounter in his many scholarly articles. With the internet becoming the “elephant in the doctor’s office,” the dynamic of medical authority has certainly changed…