This is a window posting to different list serves who are embracing a similar concept at the same time - the concept of facilitating personal growth. In one list serve the discussion began with the recent media hype about buying professional advice on admission statements and it resulted in a fine essay about the personal growth role of advisors working with student applicants (Health Professions List Serve). In the Family-L list serve the discussion focused on competence in diagnosis vs process and later resulted in a synthesis with the theme of Growing Up in Medicine.
Similar postings on somewhat unrelated list serves have resonated before and, given the nature of people who advise and teach and serve, it will likely happen again. I have great confidence in both groups of individuals, their ideals, and their works. I think that medicine is in dire need of the best minds in both areas. Clearly medicine does not care to notice the storm clouds gathering on the horizon. We need those who can encourage those students who will make the best doctors and those who can encourage trainees to be the best doctors that they can be. My best efforts are as a facilitator.
For those on the Family Medicine list serves, I would urge you to seek out those who serve as health professions advisors. I believe working with them will result in medical schools choosing the kind of students that will make better doctors and ease many of the current challenges in Family Medicine. For those on the Health Professions list serve I would urge you to take on yet another task, the task of responding to those in Family Medicine and admissions committees who would contact you and involve you more in assessing the growth potential of candidates for admission to medical school.
The potential for both groups working together is illustrated by a few stellar efforts, such as those of Rabinowitz where the 1% of graduating medical students in the Physician Shortage Area Program have resulted in 21% of the rural family doctors in the state of Pennsylvania. The application is not limited to improving the numbers of rural physicians, or even to increasing the numbers of physicians choosing underserved practices. The importance is to choose and train physicians who serve and grow. They will be the ones that will care and will keep caring. They will continue to practice competently and efficiently for the benefit of their patients and our nation, regardless of their specialty.
The following posting synthesized many of the comments on Family-L about Competence and Polarity: From Andre Lijoi <alijoi@WELLSPAN.ORG>
Patients want clinically competent physicians who listen to them and care about them. I also believe what our patients fear most about a doctor is that we won't believe them, and how easy it is for us to underestimate how frightening their illnesses, traumas, surgeries, etc can be to them.
One of my mantras which nauseates the residents sometimes is, "They don't care how much you know until the know how much you care." We must be deliberate in teaching our residents how to communicate this at each visit.
They must be able to do it without exhausting themselves emotionally and must be efficient at it. On the other hand, this type of communication can't just be an act. There has to be a genuine interest in our patients welfare expressed. I call this part of GROWING UP IN MEDICINE. It’s a process that takes us from the very idealistic through disillusionment and often cynicism and eventually to a balanced view of what we can and can't expect of ourselves, our patients and the system in which we work. It brings us to the conclusion that it doesn't have to "cost" too much to care and that is a very valuable gift we give our patients. It also helps us recognize what a gift the patients give us in their confidence and trust in us when they ask us to help them.
Of course the patients want us to be knowledgeable and competent as well. This is more easily taught. However, I wonder if our system of drumming competence into our learners sometimes drums out the compassion. I also believe that the current entrepreneurial climate which permeates our profession goes a long way to drum compassion and empathy out of us, not to mention the allegiance out of our patients. By "Lijoi, Andre" <alijoi@WELLSPAN.ORG>
In a similar eloquent way, Camille Ibbotson has also synthesized the health professions list serve comments about assisting students with personal statements and essays. Again the major topic is facilitating personal growth:
In working with students on their personal statements, I feel I'm doing more than helping them polish up an essay. Advisors are also teachers: My goal is not just to help students write strong essays, essays that give the readers a glimpse into who the writers really are, but also to help the students get to know themselves better, and to become clearer on their own motivation for becoming doctors.
Many times, after I have probed with a student into why she said this or that in her essay, she'll say, "Wait! That's not what I meant at all! THIS is what I mean to say ..." At its very best, the personal statement is AN INSTRUMENT OF PERSONAL GROWTH, and helping students with these statements is one of the most rewarding parts of my job.
Camille Ibbotson Pre-Health and Pre-Law Advisor
Loyola University Chicago
Note: Bold and Caps are my changes in each posting. I would hope that we do better in medicine to choose people who have the capacity to GROW UP IN MEDICINE. After students begin the process, it is my hope that we would do our best in our individual careers and in Family Medicine as a discipline to facilitate rather than to retard this process in each student and resident. I think all of us in both areas would agree that facilitating personal growth is one of the most rewarding aspects of our careers, whether it be with students, or patients, or colleagues, or perhaps with medical education.
Robert Bowman Rbowman@unmc.edu
Character, Color, Admissions, and Physicians