Role models in #meded

In the 70s when I trained, we had no add-on curricula; we had no milestones; we had little interference from governing bodies.  What we did have was role models. In the current century, when I talk with students and residents (and I do that very often) they talk about what they see or do not see from their attending physicians and fellow residents.  The carefully constructed curricula result from excellent intentions, but role models defeat those curricula every time. If we want our learners to show respect for diverse patients; if we want our learners to understand the struggle that many patients have with drug costs; if we want our learners to make decisions based on patient preferences, then we must have clinician educators who embody those attributes. A few months ago, we had an elderly patient who had spent 6 days in the ICU.  She had a complex medical history.  She and the family wanted her to go home.  She wanted to go home to die, because she wanted to die at home.  She wanted to go to church one more time.  She and the family were unanimous on her end of life decision making.  So we discharged her with hospice immediately. The residents told me that they had not seen such a conversation previously.  We listened and reacted in her best interest.  We resisted suggestions that she go to rehab or a nursing home, because the family wanted to have her for end of life.  The family members were remarkable.  They were sad that she was dying, but respected her feel...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs