Follow the Fad
Medical schools, guilty of doing the same rigorous training style over the past 100 years, are changing again. More and more are just following the news and trying to make a splash with cool new programs. Who is up for some interprofessional training fun? The pendulum has now swung old school didactics/rounds to “hey, the media will love this one”. As a example, students at the Medical University of South Carolina join with students from all of the university’s degree programs, including nursing, pharmacy and health administration. As the American Medical News article recounts, “During a semester, the students work in teams to solve a hypothetical patient sentinel event. They must determine what went wrong and come up with multiple recommendations for the patient’s care.” I sure hope they continue the scenario all the way out to the hypothetical lawsuit. In that example the medical student gets to find out he or she is the only one of the “team” who gets sued.
I get the “cowboy doctor days” are gone and I understand why. That being said, I have seen the “team” thing fail miserably in the real world of medicine because the wrong people without the adequate training think they should be in charge. There is still a need for a CHAIN OF COMMAND. Sounds bad and politically incorrect, but it still works.
Amen, brother!
I think that input from all appropriate personnel is required. But when things go “stinko” the MD is alone required to put thing right. Whether we like it or not, physicians have the famous Harry Truman sign on them, “The Buck Stops Here”. We are the ones who are disciplined, sued, blackballed etc. No wonder there is burnout, we are responsible for things we have no control over.
I think it is important to look at the other side of this coin. Since the doctor is the one most likely to be sued, wouldn’t it be important for him/her to consider the input of the other members of the team who will be treating the patient? This is coming from a lowly med student, but I would want more eyes and ears helping to guide my treatment plan since my time with the patient will surely be more limited than theirs.
Then you would have people that think treating a virus requires antibiotics.
Or maybe one of the nurses that didn’t think an EGD was appropriate and denied the insurance claim, but when it was performed the patient had BARRETTS.
There is a reason the doctor is the doctor. Input is one thing, but that input should be weighed accordingly so patients don’t suffer because someone that wasn’t qualified wanted to be “an important member of the team”.
As usual, Doug beats me to the joke. Oft times when nurses in the ER start prattling and grousing about an overblown workup for obvious chest all pain or simple gastroenteritis, I fire back with “Let’s see a quick show of hands, who here has been sued before? Oh, just me?! Then get the damn EKG” That usually gets a laugh, but only ’cause it’s true.
Sadly, this is a reality in hospitals today. We ARE part of group of people who help patients; I would be very uncomfortable giving TPN without a pharmacist involved, and nurses have forgotten more about mixing IV meds than I ever knew. And “sentinel events” are a dire warning of a potentially disastrous situation–example a high dose of long-acting insulin given to a hospital patient. The patient pulled through on a D10W infusion and left none the worse for wear, but the next one could end up in a vegetative state. Med students need at least to be aware that there is a way to review the roles of everybody from the pharmacy to doctor to floor nurse and work on a plan to prevent future problems.
Med Schools will lose their accreditation if they don’t change to this type of curriculum.
Many more students fail Step 1 at schools during the transition years to this type of training.
I fear it will be like New Math.
I actually disagree with you (for I think the first time). I see SOME of this as a very good idea. We all know the doctor as the guy who answers to no one is gone. On the other hand, I will admit that it took me a few years into residentcy before I figured out what the pharmacist could do for me besides hand out my prescriptions to the patient.
Also, look from the other side. If we are working with administrative and nursing STUDENTS maybe they will have abetter understanding of what we do and not treat us as moneygrubbing enemies in their later practice.