This year I’m part of a Blue Book lecture series, which means--I'm on a committee. Our first meeting was pretty disorganized, and it took a long time... which got me thinking that being on a committee is actually an excellent exercise in preparing for a career in medicine.
For the rest of my career, I will rely not only other physicians, but also on pharmacists, RNs, NPs, PAs, and techs. Medicine is a committee. Up until now I have (mostly) been able to do it alone. At least, I’ve done it alone until I couldn’t anymore and then I asked for help. More and more I am required to ask for help even when I don’t think I need it.
For the rest of my career, I will rely not only other physicians, but also on pharmacists, RNs, NPs, PAs, and techs. Medicine is a committee. Up until now I have (mostly) been able to do it alone. At least, I’ve done it alone until I couldn’t anymore and then I asked for help. More and more I am required to ask for help even when I don’t think I need it.
To prepare us for this aspect of medicine, we have a class at my school called Clinical Applications in which we're given a few articles to read on a particular disease. Then we split up into small groups (7-8 people) and we have to answer a series of questions based on a case study.
To me, this class is sort of obnoxious. Like many undergrad classes, it feels like a game of Lets Pretend. Like pretending to observe what you know should happen in Physics lab, just so you can get out of there.
We might, for example, have to decide whether or not to give an imaginary patient Dilaudid. I understand the idea behind the class, and I believe it’s a good one, but I don’t devote the same level of thought and consideration to an imaginary patient that I would to an actual human being.
We might, for example, have to decide whether or not to give an imaginary patient Dilaudid. I understand the idea behind the class, and I believe it’s a good one, but I don’t devote the same level of thought and consideration to an imaginary patient that I would to an actual human being.
If I thought our discussion would result in real action, I would: 1) prepare much more thoroughly, 2) state my conclusions more assertively, and 3) think more carefully before I made any decisions. The problem is that when we know something doesn’t “really” matter, we blow it off. (By “blow it off,” I mean: prepare just enough to do well, but not enough that we’d have an intelligent question to ask a world-renown expert.)
But how could our faculty improve the class? The only solution I can think of is lying to us—convincing us we’re making actual decisions about patient care. But that’s a bit ethically flawed. (If they told me my decision killed a patient, for example, then said, “Gotcha!” I might be a little bit disturbed…)
So, as with most things: I just don’t know…
And not only will you have work as a team, you will have to rely on others to execute your orders. (chuckle) You will also have to be proficient in explaining elaborate and complex medical concepts to lay people, i.e. may of your patients. I am still working on that one....maybe you will have some new strategies to share. And don't forget to 'practice like you play.' I know those problem-based learning classes seem silly now, but trust me....that's the most basic way to develop your clinical reasoning skills in a slightly less stressful environment than the ICU, for example. But I do think having meetings about meetings is ridiculous and I ALWAYS will. ;)
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