Connecting The Dots of Healthcare

A few months ago I was speaking for a hospital TAP, (trustee, administrator, physician), executive retreat in New Orleans. One outstanding dinner was at Antoine’s but it was the food for thought that still lingers from a conversation with a physician and his wife, Donna. Donna’s a lawyer. This doctor/lawyer discussion was memorable and insightful.

There is an art and science of medicine. But medical training, starting as pre-meds in the broadest terms, is science, not humanities orientated. Even in grade school, the kids who “want to be doctors” are the ones who generally enjoy and excel in science.

Give a class full of first year medical students on their very first day this quiz. 

CHECK ONLY ONE RESPONSE:  “I think like a science professor?” or “I think like a humanities professor?”  

Which do you expect gets more votes?

Physicians are good at science. To gain entrance to medical school, we must be proficient at calculus, chemistry, (organic and inorganic), biology, and physics. Oh, and we’ve got to do at a minimum a semester in English composition and one semester class in English literature. (And that’s what we typically do, the bare minimum in English) In medical school even our study of psychiatry is still scientifically oriented. We’re scientists aren’t we? In residency we don’t write reports, we do history and physicals! We read scientific journals and write our own scientific articles for publications in (hopefully), prestigious journals.

Unfortunately, the day we complete our training and start practicing medicine, we stop being “scientists” and become “humanists.” Most of us don’t continue to write scientific articles, rather we try to communicate with humanity. And most of us fail. Better doctors learn and grow to become “humanists,” but others never try. And even the most scientific among practicing physicians today might have trouble remembering how to use a mathematical integral!

Lawyers on the other hand typically don’t take any science other than minimal college requirements. My brother is a public defender in Charleston, SC. I don’t think he knows the difference between a Florence or an Erlenmeyer flask because he was an English major. But his communication skills, written and verbal, allow him to communicate extraordinarily well with all levels of humanity with compassion and understanding. Undeniably bright enough to get into medical school, there simply was no appeal to him in what I chose. Curiously,  Wikipedia lists the Erlenmeyer Flask and The Erlenmeyer Flask and has a longer entry for the one describing the first season’s final episode of The X-Files… a ”scientific?” TV show that speaks clearly to humanity. What’s clear is that the pseudo-science of The X-Files or even Dr. Welby connects better with humanity than the majority of “real” doctors!

Chris Carter, the originator of The X-Files, majored in journalism and was a globetrotting freelance writer and first worked for a surfing magazine. His brother, Craig, is the MIT Engineer. Whoaaa, DUDE! I’ll bet Chris didn’t take a load of lab sciences at Cal State Long Beach but no doubt his world experience with, HUMANITY, helped him connect with the public in a way to create an icon of mass media.

As college pre-meds we were known, often actually self-celebrated, as being grinds. The handful of law students and business students I met when in Medical School always seemed to be at parties, many were married, (some of my med school class were married, but often to someone who was “scientific”), and by contrast, spent a lot less time in “school” or study than med students. When we were swallowed up by residency programs, even a new law graduate, (after only three years of study vs. our four), I don’t care how “hard” working at an entry level in a legal firm was described, most of these new lawyers got to sleep at home more than my every other night. Most of these recent law school grads didn’t define a “good day” as I did. (My “good day” was a 48 hour day where I got to be home for 12 hours out of the 36 and got more than six hours of sleep on my “night off.”) We boast about how “hard we work” as physicians. But WHO CARES?

And now the long hours of residency are assailed and call is limited. Wimps or Wisdom? If changes in medical education allows more time for developing physicians to explore humanity in more depth, to live a fuller life, and to expand our ability to connect with humanity, perhaps we woudn’t be as socially crippled as we physicians often seem to be.

Perhaps we can swing the pendulum back a bit from science to the art of humanity. But today, we’ve lost to the lawyers. I don’t see the federal government telling lawyers how much they can charge our Medicare patients for a house closing.

Having a physician who is knowlegeable in science is a good thing for patients. But the truth is, patients don’t care how much we know until they know how much we care. There is an ART and science of medicine to be balanced. 

 Possibly all physicians should be required to take a course in surfing to help with learning balance and developing a deeper appreciation, respect, and connectivity for humanity to be found in waveforms other than EKGs?