Teaching Being an Ethical Doctor: The Physician Role Model and Humility
There is a need for a good role model for medical students and residents as they learn the skills and burdens of medical practice. I think that the most effective role model would be a physician mentor. But that physician mentor needs to have qualities beyond the teaching of diagnoses or medical and surgical techniques. In addition the role model must also be an example of the best in professionalism with the understanding of ethics but also the simultaneous practicing of ethical behavior that becomes obvious to all those he or she mentors. Unfortunately, as I have mentioned in previous posts, there is a “hidden curriculum” in the later years of medical education that, as being practiced by poor role models, is morally destructive. This must change.
One of the important qualities a physician model should demonstrate to the students and residents is that of personal humility. Humility, the ability to give up some of one's self-importance and assertiveness and show them that there is merit in the practice of medicine to listen to the advice and concerns of others. This means not only listening to and considering, even accepting, the advice and concerns of colleagues in one's own discipline but also the concerns, advice and point of view of those from other disciplines and from the patient and finally also from those students and residents who look up to the model. It is hard for some doctors to shy away from expressing their self-importance.
- Philip James Baley wrote: “Lowliness is the base of every virtue,
And he who goes the lowest builds the safest.”
Physicians, by themselves, are not always right in what they know, what they say and what they do. They need the feedback of others. Without behaving with humility, all the other virtues a physician might express
may give way and lead to misjudgments, medical error and absence of trust by colleagues and patients. In conclusion, I would tell students: “Physician, Be Humble”...Maurice
posted by Maurice Bernstein, M.D. @ 5:18:00 PM
3 comments
3 Comments:
Humility = approachability.
Without being "approachable," the real candidness and trust the patient could have for the physician, will more than likely be absent, or at least, diminished.
I wish all physicians went through your classes, Dr. Bernstein.
I would agree, Moof, that "approachability" is a direct consequence of a doctor's behavior regarding humility. You know, it is so ironic that a physician may expect approachability by the patient (allowing the laying on of the doctor's hands as part of the physical examination, telling the doctor intimate details of the patient's history and the willingness to be complient with the doctor's advice) and yet the doctor's behavior may inhibit the patient from making intellectual or emotional contact and communication with that doctor. This inequality smacks of paternalism. This inequality can be expressed as the physician stating to the patient "I must know all about you since I know what is right for you but you have no right to know about my intellectual, physical or emotional weaknesses nor are you allowed to challenge my decisions." I think that this unequality of the playing field within the doctor-patient relationship cannot be considered satisfactory for the provision of the best medical care. This because the doctor-patient relationship is a very personal relationship and needs the trust of the patient. Without that trust, the best in treatment and care is a hollow exercise. ..Maurice.
I don't think the students need good doctors as preceptors. They only have to be good if you bill them as 'mentors'. Give them a neutral name, like preceptors, and they can be horrible. Tell the students to carry two mental bags. Put the good stuff in the good bag, and put that bad stuff in the bad bag. Not only should they emulate the good, they should remember the bad stuff and make sure they don't do or say those things themselves.
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