by Sneha Sudanagunta, OMS-III
Originally published in the May/June 2020 issue of the Tarrant County Physician.
Medical schools emphasize two main concepts throughout the first two didactic years: medical knowledge and humanism—the art of forming human connections. The first encompasses learning the ins and outs of normal and pathologic functions of the body, different disease states, and how to properly diagnose and treat diseases. This, some can argue, is the most important aspect of medical school. Medical students spend countless hours during the first two years learning as much as they can. During their clinical years, they’re “pimped” on what they learned the first two years and learn how to integrate their book knowledge into the real world. The latter concept, humanism, focuses on the actual human contact part of being a doctor. This includes showing empathy, communicating appropriately, and partnering with patients. During the first two years of medical school, most schools teach humanism through interactions with actor patients. During this course, we are evaluated based on these aspects of humanism. Even our national board exam tests our ability to communicate with patients and empathize with them. It’s engrained into how we interview patients and it seems to come naturally. It’s why we all went to medical school in the first place, right? To help those in need.
However, that’s not how it always works in the real world. Medical knowledge is increased every day and every physician I have encountered during my third-year rotations has an immense fund of knowledge. That aspect of education continues past medical school. In my experience, however, the humanism aspect seems to be dwindling from memory every year a physician is out of medical school. Is this due to burnout? Can it be because physicians become jaded? Or is it because doctors are so overworked? Whatever the reason may be, physicians must strive to remember why they began this journey and keep humanism at the forefront.
“Physicians must strive to remember why they began this journey and keep humanism at the forefront.“
As a third year medical student, I have noticed that appropriate communication with patients is not as emphasized in the real world as it is in our preclinical years. I have seen patient interactions where physicians take the extra minute to educate their patients, and I have also witnessed many occasions where patients are left with more questions than answers. The difference in patient care and outcome is shocking. A young adult female came to the OB/GYN clinic for increased uterine bleeding and had been taking three times the recommended oral contraceptive dose for two weeks longer than protocol. When this mistake in drug use was explained to her, she said she never fully understood the instructions the ER doctor gave her about her new medications. The mother of a five-year-old boy in the hospital for rhabdomyolysis was told her son had high liver enzymes and was transferred to this hospital for better care without further explanation of the disease. I watched as the fear of her son having liver disease left her eyes when I explained to her what rhabdomyolysis is and how it can falsely elevate liver enzymes. When a patient hears 60 percent ejection fraction, do they understand that their heart is pumping effectively and not that it has lost 40 percent of its function? When doctors use words like peritoneum, cardioversion, or even EKG, do patients truly understand what they’re saying or do they begin to zone out?
This is where the ideologies of patient communication that are engrained in us as medical students need to shine. Humanism isn’t just about caring for patients; it’s about effectively communicating with them. As we’re taught in medical school, effective communication includes using language the patient will understand, educating them properly on their disease processes, and developing a treatment plan that the patient is comfortable with and able to maintain. Though knowing medical concepts is imperative as a physician, our job doesn’t end there. We have the unique opportunity to be more than just doctors. We are educators, confidants, and our patients’ best advocates. If we have the ability to be all of these things, why stop at being just healers?