REFORMING MEDICAL TRAINING

The problems embedded in doctor–patient relationships has led to pressure for reform from both inside and outside medicine. Many doctors now believe that ris- ing rates of malpractice suits largely reflect patients’ disenchantment with doctor– patient relationships rather than with the quality of care. In fact, research suggests that even in cases of gross malpractice (such as removing the wrong rib), patients are far less likely to sue if doctors openly admit their error rather than hide behind their mask of authority. The AMA and the American Hospital Association both now encourage doctors to admit their errors to patients and their supervisors; Similarly, throughout the United States, medical students and professors are now working to implement innovative programs for integrating more patient- centered perspectives into the medical curriculum. In the past, students typically spent their first two years studying biology and anatomy and rarely interacting with patients, but now many medical schools introduce students to patients much earlier in their training. At Dartmouth Medical School, for example, students must shadow a community physician once or twice weekly throughout their first year so they see from the start what it means to work with patients. At New York University, students spend part of their first week in medical school listening to lectures by persons living with various diseases. And at Yale Medical School, stu- dents are introduced regularly to “patients” (played by actors) whose job is to show them what illness looks like from patients’ perspective and to challenge the idea that illness is purely a biological phenomenon.