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Great Scores Don’t Necessarily Mean Great Doctors

Monday, April 16th, 2012

If you’re planning to go into the medical field like I did, then you’re probably aware of the strict application process most medical schools will put you through.  If you don’t have the right grades or MCAT scores, you might not get into the school of your choice, no matter how badly you want to help people.  Unfortunately, this means top medical schools are letting in bright students who are great test takers, but who can’t take care of patients.

Being a physician is about much more than memorizing information from medical encyclopedias and science classes.  I’ve found that a strong sense of empathy and compassion for others, as well as a generosity of spirit has been crucial to my success in medicine.  It allows me to put myself in my patients’ shoes, which in turn gives me a better sense of what to ask and what to look for.

Many aspiring doctors don’t have the grades to get them into the top schools, but they may have more emotional intelligence than the students who beat them out for those spots.  Eventually, the positions of physicians are filled with very smart people who just don’t seem to take the time or care patients need.  It takes patience to listen to everything a patient has to say and then to dig even deeper.  It’s not about solving a puzzle as fast as possible.  It’s about understanding underlying issues that may not be obvious at first glance and knowing how to uncover them tactfully. It all goes back to bedside manner, which seems to have disappeared in an absurd dichotomy of doctors having the attitude “I know it all and you know nothing”. Doctors must listen to patients. Our patients know their bodies better than their doctors do. After all, patients live in their bodies. We only visit those bodies.

Luckily, after three years of study, the American Medical Association has realized this and is encouraging medical schools to look deeper into their potential students than just their test scores.  As a result, many are adding comprehensive interviews that attempt to find out who the applicant is as a person, not just as a student.  The Association of American Medical Colleges has also announced that it will be changing the scope of the MCAT exam to include more emphasis on psychology, sociology, and biology.  President of the AAMC, Darrell Kirch, said about the changes, “Being a good doctor is about more than scientific knowledge.  It also requires an understanding of people.”  I couldn’t agree more, and I hope this changing philosophy will help bring patients more compassionate and effective doctors.

— Yvonne S. Thornton, M. D., M. P. H.

The Problem With Part Time Doctors

Friday, June 24th, 2011

As anyone who has read either of my two memoirs knows, I’ve worked long hours as a ob-gyn/maternal-fetal medicine specialist, throughout my career. While it’s been a challenge, at times, and I’ve had to juggle like crazy to be the kind of mother my children could always count on, it was the life I signed up for.

I don’t regret my career choices.  Becoming a doctor is as much a calling as a profession.

So, when I read an op-ed by a woman anesthesiologist, which criticizes a recent trend among women doctors to think of medicine as a part-time career, it struck a chord.

This section, in particular, offers food for thought:

Since 2005 the part-time physician workforce has expanded by 62 percent, according to recent survey data from the American Medical Group Association, with nearly 4 in 10 female doctors between the ages of 35 and 44 reporting in 2010 that they worked part time.

This may seem like a personal decision, but it has serious consequences for patients and the public.

Medical education is supported by federal and state tax money both at the university level — student tuition doesn’t come close to covering the schools’ costs — and at the teaching hospitals where residents are trained. So if doctors aren’t making full use of their training, taxpayers are losing their investment. With a growing shortage of doctors in America, we can no longer afford to continue training doctors who don’t spend their careers in the full-time practice of medicine.

… The Association of American Medical Colleges estimates that, 15 years from now, with the ranks of insured patients expanding, we will face a shortage of up to 150,000 doctors.

When you look at training in the medical profession as a scarce resource, provided to a small number of people, in whose hands others place their lives, you can see that it isn’t the kind of career choice you make lightly. It’s a commitment. And those who don’t feel the need to fully commit, who think of it as a profession in which they can dabble, do a disservice to the patients who need them, as well as to those who would have committed fully to the profession, if only they could have gotten into medical school.

In our do-your-own-thing society, this might seem like a harsh, even an unfair judgment. But medicine isn’t practiced for the benefit of the practitioner. It’s a service to our fellow men and women. And as long as there are so few of us that some people have long waits for needed care, those who choose this profession must be willing to be there when they’re needed. And if they can’t? There are plenty of other professions with lesser requirements.

– Yvonne S. Thornton, MD, MPH