BEYOND THE DIAGNOSIS

 

"The purpose of life is ... to be compassionate, to have it make some difference ..."

Ralph Waldo Emerson

Instituted in 1995, Empathy Sessions were developed in response to an observation by a group of faculty that medical students seemed more compassionate than their physician peers. It appeared that the prolonged training period of a physician, with its emphasis on scientific knowledge, stamina, and independence contributed in a negative way to the “hidden curriculum” and resulted in a dispassionate, less caring physician. In an attempt to reverse this tendency, we created a voluntary small group experience called Beyond the Diagnosis (BTD) as students progressed through the curriculum.

RELEVANT READINGS:

In the What Doctors Feel: The Darkest Year of Medical School by Danielle Ofri MD 

https://slate.com/technology/2013/06/medical-school-dark-side-the-third-year-makes-students-less-empathetic.html

Unexpected Deaths: “Praying with Your Patient Before Surgery” 

https://www.doximity.com/articles/98138d62-ede4-49a0-89de-378ebc12a329

Year 2: Beyond the Diagnosis (BTD)

Advocacy

  • How do we maintain the balance between clinical and emotional involvement?
  • How do we avoid judging patients?
  • What is our role as advocates of patients' needs?

Reading:  "Joe the Handyman."  and "More than 'A Case of Fragile X'"  

Patient/Family Perspective

  • Do physicians have to have a serious illness to know how to interact with patients?

Reading:  “The Clinic Visit”  and “Even Better” 

MD/Team Relationship Making a Difference

  • How do doctors and nurses interact?
  • What are ways to facilitate communication?
  • How do teams make a difference for patient outcomes?

Reading:  “The Half-Wall” and  AAMC Readings (To Know by Heart, Navigating, First Trimester, Caring for a Child, A wedding and a Funeral, Remembering family, Words, Moment of silence)

What Doctors Feel

  • How can you connect with patients you may honestly find repulsive?

Video, by Danielle Ofri MD 

To Feel or Not to Feel

  • Should physicians show their feelings to patients and families? 
  • How do you deal with families when things are going wrong? 
  • Where is the line between being a compassionate physician and being “too involved”?

Reading:  “Healing Hearts” and What Would You Do if It Were Your Kid? 

Unexpected deaths and tragic mistakes

  • How do you deal with the loss of a patient?
  • Personalizing painful experiences.
  • Vulnerability of ourselves when caring for patients.

Video Link “Sully” (12 min)

Reading:  “The Surgeon.”, “What I Learned About Adverse Events from Captain Sully”  and
“Praying with Your Patient Before Surgery”

Going Beyond the Presenting Situation &First Impressions

  • How do you avoid generalizations when you see a typical presentation?
  • How far is a physician expected to go in helping patients recognize/deal with potentially harmful lifestyle issues?

Reading:  “The Intervention.”  and “A Good Cry” 

Presence

  • How should we approach traumatized patients, families and care givers?

Reading:  “What I do Not Tell the Medical Student” NEJM and  “Learning Not to Move Forward”