Back to Basics

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Excerpt

Who receives the most thank-you letters from patients in the Smilow Cancer Hospital at Yale-New Haven Hospital? Interestingly, custodians carry that honor, although dining and transport personnel also receive a significant share of patient gratitude.
When David Vinas, the director of operations at Smilow Cancer Hospital, shared that information with me, I was a little surprised that clinicians didn’t top the list. In retrospect, I shouldn’t have been. The reality is that doctors and nurses spend the least amount of time forming a human connection with their patients.
The Yale School of Medicine is trying to teach us future clinicians how to better connect with our patients. For the first time, all medical, nursing, and physician assistant students are participating in an “Interprofessional Longitudinal Clinical Experience,” which exposes students to the clinical setting at the very start of their education. The idea is to address the biases that different health care professionals may have toward each other. Other initiatives at Yale, like the “Program for Humanities in Medicine” and the “Introduction to the Profession” course, all try to cultivate the well-rounded physician. Although these programs teach us valuable clinical skills, I still find our education in developing the human connection to be lacking.
In a changing environment where doctors are less patient advocate and more data-entry scribe, teaching medical students to be kind, caring, and empathetic is like telling someone stuck in quicksand to relax and cheer up.
Yet Smilow Cancer Hospital may be onto something. David Vinas says he educates his staff about a “10–5 rule,” which means as you approach a patient or family member 10 feet away, you should make eye contact and smile. When you’re 5 feet away, you should greet them verbally: “Hello, good morning!” Simple, right?
But they don’t train us medical students this way.
In our hurried lives composed of shadowing or studying for the boards, we often begin skimping on the eye contact, the smile, and the greeting. Perhaps if we go back to the basics and practice good manners and etiquette with everyone we meet, we’ll go a long way toward improving the patient–physician relationship.
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