Medical Student Reflection III

by Academy of Clinical Excellence on January 4, 2013

I embarked on this short journey – a two week elective during which I shadowed one or two members of the Miller-Coulson Academy of Clinical Excellence each day – to observe the practice of medicine by physicians who have been deemed “clinically excellent.” As a third year medical student just beginning my rotations on the wards, I feel that now is the perfect time to reflect on the type of physician I want to become and the clinical habits I’d like to develop.  With one core rotation under my belt, I’ve discovered that this isn’t easy to do when most of my attention is directed toward learning the details of clinical signs, diagnoses, and treatment plans.  I saw this elective as an opportunity to follow excellent clinicians and really focus on the art of medicine rather than the content of it.

So why are these physicians considered clinically excellent?  They have been inducted into the academy for both the technical quality of the care they provide as well as the more personal side of their approach to patients.  I’ve spent only a few short hours with each of the members I’ve shadowed, which isn’t enough time for me to make informed judgments about their diagnostic acumen, medical knowledge, or other technical aspects of their care.  The interpersonal aspect of their interactions with patients, however, has been immediately evident.  

Each physician has his or her own style and personality when working with patients.  From joking with them to chatting about sports or hobbies to being upfront and to-the-point, all of the doctors I have shadowed have had their own way of connecting with patients.  There are three qualities or habits that I observed in nearly every one, though. 

  • The first habit that I noticed was the simple act of making physical contact with patients.  Some physicians chose to shake hands with the patients and the family or friends accompanying them.  Many chose to touch patients on the arm, whether it was during moments of humor or after a sad story.  A few even hugged some of their longstanding patients during the visit.  That little bit of physical contact immediately put patients at ease. 
  • All of the members I observed also truly listened to patients.  They rarely interrupted and I remember one appointment where the patient spoke for 7 minutes without a peep from the physician beyond an occasional “mhmm.”  A number of patients even commented on what amazing listeners the physicians were, and cited that as the reason they thought they were good doctors. 
  • The third quality that I noted was expressed in different ways by each member, but was evident in every patient interaction.  All of the physicians I shadowed had respect for their patients and cared for them as a whole person.  Some of them showed it by asking specifically what the patients’ goals of care were for making treatment recommendations.  Others did it by listening to questions and concerns about health problems that were not pertinent to the current visit or in the realm of the physician’s expertise.  Still others asked about patients’ personal lives both to get to know patients as people and to ensure that they had safe home environments.  A few checked to make sure that they could afford all of their medications, and one even showed that he cared just by spending five minutes looking for a remote control so a patient could turn up the volume on his television. 

- Rachel Meserole, MS III

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