AAMC 2014: What Motivates Someone To Go Into Medicine?

Disruptive physician behavior was a big topic on day one at the AAMC convention. After Lorris Betz's, M.D., Ph.D., talk on physicians behaving badly, we asked two medical students what their experience was with this issue. Tyler McKinnish and Faraz Alizadeh talk about what constitutes mistreatment and why they're optimistic about the future.

Transcript

Announcer: Broadcasting from the Algorithms for Innovation Booth at the AAMC in Chicago. The Health Care Insider is on The Scope, University of Utah Health Sciences Radio.

Interviewer: So we're talking to Tyler McKinnish and Faraz Alizadeh, they're both medical students here and they're into AAMC meeting. Faraz is at the Albert Einstein College of Medicine and Tyler is at the University of North Carolina at Chapel Hill School of Medicine. First day at the AAMC, what have you picked up? What is the big take away that you've had as a med student?

Alizadeh: I think the thing that I'm happiest to take away, that's been the most impactful is there was this issue of the culture of medicine and there's this culture that often leads to mistreatments. And hearing a physician talk to another group of 3,000 physicians, saying, "We have a problem in our culture, we need to change it."

And showing specific examples of how one particular institution did that, the University of Utah, that was really empowering. And that was nice to see that it wasn't just something that we're learning in medical school, for example. And then when we go off to the hospitals, they're going to tell us that it's not important and that we're just going to have to go with the way things have been.

Seeing that other attending physicians, that they are abdicating for a change in culture, that was really something I think I'll take away.

Interviewer: Have you witnessed any sort of physician with that behavior, so far? Or are you aware of it, or is it something you talk about, or I mean . . .

Alizadeh: So our schoolmates have a very big point . . . that have a big examples in this treatment, for example, physical abuse, or humiliation, or those that don't exist, but there's still small things in the culture. For example, when I introduced myself to a chief resident, some are great, some are really excited to meet me and see who I am. But others just kind of overlook me, and..

Interviewer: Kind of dismissively?

Alizadeh: Very dismissively. Like I'll introduce my name for example, they'll say okay, and they'll walk away. And that's not necessarily mistreatment, but it's not the culture that we should have in a career that's focused on serving the community.

Interviewer: And also what's said in one of the sessions today, in a career where we need to come together as a community in order to not burn out, not have these feelings of frustrations, so interesting. Tyler, how about you? Have you witnessed any examples of physician bad behavior?

McKinnish: No, I actually haven't directly. Our institution also is acutely aware that, that is historically has been a problem. And I think people are becoming more and more sensitive to the facts that medical students are at a very formative point in their career. And that the more supportive we can be to medical students, even to people who are shadowing, to anyone on the path towards becoming a physician, the more likely we are to build empathetic future providers.

Interviewer: That's an interesting thought because your whole culture is supposed to be empathetic towards the patients. But yet then towards each other, you're not nice. I mean, that doesn't make any sense, does it?

McKinnish: No, it doesn't. And I think that actually is reflected in curricular changes. At a lot of medical schools right now, there's been a shift away from grades towards pass-fail curricula. I think in large part, because there's a motivation to increase cooperativity between medical students to make the entirety of medical school really a team experience. Really, I think our entire health system should be supporting the patients better, in it, as a team. We should all be working together.

Interviewer: But if you are not supporting each other as physicians, how are you going to do that to the patients?

McKinnish: Exactly.

Interviewer: It's like Alan Alda, did you see Alan Alda this morning?

McKinnish: He was wonderful. I loved his talk this morning.

Interviewer: He said, he likes to get his actors together and laugh together for an hour together as a group. Because then as a group they go out and they do great things for the audience and I think that's another analogy that can apply here. What's the biggest take away you've had so far?

McKinnish: Actually I think it's interesting that you brought that up. I thought that Alan Alda's talk this morning was really great. He brought up two things about communication and I think are really important in medicine and in education as well. One is clarity and two is empathy. I think those are two things that really have to be a component of medical education and have to be a component of provider patient interaction. Empathy and clarity are so important and are so often forgotten in medical curricula or historically have been. And I think that was a really great point for him to bring up.

Interviewer: How are you going to implement that in your life now? That's a tough question isn't it?

McKinnish: A really tough question.

Interviewer: I guess awareness is the first step. Just to be aware that that's what you want to try to achieve.

McKinnish: The point that he's trying to make is that communication has to be succinct and has to be on the level of the patient. You really have to meet people where they're at.

Interviewer: Both emotionally and with the words you used for the information [inaudible 00:05:01].

McKinnish: Exactly.

Announcer: Sparking conversations to transform academic medicine. For more, stop by our booth at AAMC, or go to Algorithmsforinnovation.org. TheScopeRadio.com, University of Utah Health Sciences Radio.

By: Scot Singpiel

Scot Singpiel is senior producer for TheScopeRadio.com.