How a physician was taught in medical school impacts his or her approach to the delivery of care.  But, medical research has made such significant gains that some physicians may want to re-frame their training with new thinking.

At the New England Society for Healthcare Strategy conference titled, Clinical Care Innovation in an Era of Reform, Thomas Lee, M.D., an internist and cardiologist, and  network president for Partners Healthcare System and chief executive officer for Partners Community HealthCare, Inc, in Boston spoke about “Chaos and Organization in Healthcare.”  One of the many interesting comments he shared was that when he was in medical school, he was taught that as a physician treating patients, he should never consult a text book or any other kind of resource in front of the patient.  He was to appear knowledgeable and well informed and to rely on other resources would undermine this presentation.  Dr. Lee, a man in his mid-fifties, still marvels at this training and realizes it does not serve his approach today.

After hearing Dr. Lee, I read a New York Times article, “Making Healthcare Better.” The article is well worth a read but I was struck by the following paragraph as it evokes Dr. Lee’s very concern about his medical training:

We may still want our doctor to be like Marcus Welby, but our great fortune is that he cannot be. Medicine has made too much progress. The range of cures and treatments is too vast. Every year, medical journals publish hundreds of new findings that doctors are supposed to synthesize. Yet somehow, both doctors and patients have come to imagine that a physician can accomplish far more than any human being reasonably can. As a result, modern medicine is accomplishing far less than it reasonably should.

In view of Dr. Lee’s comments, I can see why there is tension for physicians in how they discuss health concerns with patients and how they choose to apply evidence-based medicine to their practice – if they choose to do so.  Because we are fortunate to live where the advantages of medical research are made available, we have much to be thankful for.  As history informs us, technology sometimes gets ahead of our ability to create new systems to best manage the advancements.  We might be in the midst of that scenario right now and will need to look to pioneering models like Intermountain Healthcare as they help move the art and science of medicine into a well-honed but incrementally different practice.