Once again, the people are thirsting for our action. For doctors and healthcare academia to come forward as the personal health advocates they believe us to be. Yet the biggest factor in why we, as a collective profession, have not?
Well, too often, we’re lousy team players. We are highly trained to compete with one another for ranking, for the best residency, the best fellowship. We are highly trained in medical school to understand the details of medicine, but we aren’t trained to be policymakers, to understand business models. In private practice, we quickly learn to compete for prestige, for patients, for contracts, for money. We often don’t relate well with nurses and other members of the healthcare team. When it comes to teamwork and coordination, we are very often just sorely lacking. It’s sad, really.
We are collectively lousy at communicating. We’re great at teasing apart complex details to arrive at complex diagnoses, but we get no instruction in breaking down complex issues to a layperson. The commonest complaint I hear from patients is that their doctors don’t talk to them, or when they do, they don’t understand what they’re saying. How is that possible? People trust us to be their expert advisers, yet we can’t, all too frequently, communicate? And if we can’t communicate on a one-to-one level to a captive and interested audience, how do we get complex issues across to the media, arguably a much less forgiving forum? Or to Congress, even less forgiving?
For one thing, we can teach our physicians-in-training how to engage and collaborate with colleagues, how to actively develop public policy with leaders as physician-experts, and how to unify and lead our profession. Winning a grant award for advanced subspecialty training in critical needs areas three years ago, I and John F. Toney MD developed a training experience for Hospital-Acquired Infections and Antimicrobial Stewardship with this goal in mind. As best I could determine at the time, this was the first program of its kind in the country.
Still new territory, the fellowship epidemiology program is a work in progress. Yet already, our antimicrobial stewardship program is paying for itself by saving over $100,000 pharmacy dollars and saving patients from the significant risks of unnecessary antibiotic exposure. And already one of our graduates has been selected to develop and run an Antimicrobial Stewardship Program at a regional hospital, with her training offering a significant advantage to her curriculum vitae. We expect to follow up closely and see what worked for her and how we can continue to improve the fellowship experience. I am certainly confident that she has more experience at this point than probably many graduating fellows this year, and much more than any had only 2 years ago. In that alone, I feel the grant program has been a huge success.
Take a longer view, and we can do the same much earlier, at the medical student level. We can SELECT our future leaders, by teaching them how it’s done. In fact, USF Health’s Vice Dean of Educational Affairs, Dr. Alicia Monroe, is doing just that through the exciting and innovative SELECT MD Program (Scholarly Excellence. Leadership Experiences. Collaborative Training.). In partnership with Lehigh Valley Health Network in Allentown, PA, LeHigh Valley medical students will spend their first 2 years at USF in SELECT training, then complete clinical studies back at home.
I just cannot wait to see where they all go from there. I am so proud of our visionary ID Division and University. Be the change!
[Previously published on Infectious Bytes on September 11, 2011]