In the Jan. 9 issue of the Journal of the American Medical Association, Rochester physicians reconsider the very definition of what makes a good doctor. The authors propose sweeping changes to ensure physician competence in typically overlooked areas such as teamwork, interpersonal skills, clinical reasoning, and managing ambiguous clinical situations a necessary real-world skill that traditional schooling doesnt teach.
For patients, its not enough to know that their doctor scored well on a multiple-choice test, says principal author Ronald M. Epstein, M.D., a practicing physician in the Department of Family Medicine, who has spent his career researching and teaching about the patient-physician relationship. In the JAMA article, Epstein points out that sometimes, student doctors who perform especially well on standardized tests are especially lacking in such traits as empathy, responsibility, and tolerance.
Many of the ideas are already embodied in Rochesters new curriculum and are rooted in Epsteins search for ways to train better doctors. As a family physician, he took a broad view of what constitutes competent medical practice. After examining the ways that medical students are being taught and assessed, Epstein found that not all the right questions were being asked.
There were lots of studies of the reliability of assessment instruments, but very little on whether what we assess is really what matters in medical care, says Epstein. More troubling was that few people ha
Contact: Mark Liu
University of Rochester Medical Center