Monday, January 26, 2009

The total package: A skillful, compassionate doctor

INDIANAPOLIS, 26 jan 2009 – Patients and their families want physicians who are gifted in diagnosis and treatment and who are caring individuals with the interpersonal skills needed to communicate complex information in stressful circumstances.

A new study in the January 2009 issue of Academic Medicine shows training physicians to be humanistic is feasible and produces measurably better communicators.

"Humanism in medicine isn't about sitting and singing Kumbaya, it is about taking the individual patient's concerns and values into account in his or her treatment," said study co-author Richard Frankel, Ph.D. "Those values are clearly linked to higher quality of care and reduction of medical errors yielding safety improvement." Dr. Frankel is a professor of medicine at the Indiana University School of Medicine and a Regenstrief Institute research scientist.

The study was conducted at five very different medical schools – Emory University School of Medicine, Indiana University School of Medicine, the University of Rochester School of Medicine, Baylor College of Medicine and the University of Minnesota Medical School – rather than only one institution. The authors believe their findings are generalizeable throughout American medical education.

The 2001 Institute of Medicine report, "Crossing the Quality Chasm: A New Health System for the 21st Century," highlighted the benefits of patient-centered humane care that is respectful of and responsive to patients' needs, values and concerns.

The concept of humanism in medicine and patient-centered care predates the 21st century. In the 1920's Francis Peabody, M.D., wrote that "the secret of care of the patient is caring for the patient" a humanistic concept that in the intervening years has become overshadowed by a preoccupation with technological advances in medicine, the same technology that resulted in the development of antibiotics and thousands of other life-saving drugs, sophisticated scanning devices and untold number of vital therapies.

"Traditionally medical school curricula have focused on the pathophysiology of disease while neglecting the very real impact of disease on the patient's social and psychological experience, that is, their illness experience. It is in this intersection that humanism plays a profound role," said Dr. Frankel, who is a medical sociologist.

"As educators, we aim to foster the development of future physicians who are competent both technically and interpersonally. Patients, their families, and the public expect no less of us. This study suggests there are various faculty development processes that will allow us all to pursue these aims more effectively," said study co-author Thomas Inui, M.D., I.U. School of Medicine associate dean for health care research and Sam Regenstrief Professor of Health Services Research. Dr. Inui also is president and CEO of the Regenstrief Institute.

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Other authors of the study, which was funded by the Arthur Vining Davis Foundations, are William T. Branch, Jr., M.D., of Emory University; Catherine F. Gracey, M.D., of the University of Rochester; Paul M. Haidet, M.D., M.P.H., of Baylor College of Medicine; Peter F. Weissmann, M.D., of the University of Minnesota Medical School; Paul Cantey, M.D, M.P.H., formerly of Emory and now of the Centers for Disease Control and Prevention; and Gary A. Mitchell, M.D., formerly at the IU School of Medicine, now with the American University of the Caribbean School of Medicine.

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