Thursday, October 11, 2018

Tuition Free Medical Education: A potential game changer

In an earlier article, I focused on the many years of study-often over 18 years after High School-it takes for a pre-medical student to actually practice his specialty.

On Becoming a Physician: Pre-medical students 'shadowing'
a doctor as he makes his rounds

 At nearly age 40, he/she is now burdened with hundreds of thousands of dollars of crippling educational debt.

 This situation is the catalyst for several avenues of stress. First, the pressure to repay the loans forces many doctors to choose high-paying specialties-- when they would otherwise choose less lucrative ones such as family medicine(primary care) --an area whose shortages could total an alarming  35,000 by 2025 and even much more by 2030.

The financial stress has further ramifications once our doctor begins to see patients.

Unwittingly or wittingly, our caregiver is, in many specialties, forced to sacrifice a leisurely in- depth doctor/ patient relationship (refer to The Model of Empathetic Medicine : The Way it Was) in favor of short cursory visits in order to see as many patients as possible per hour.

Now comes an eye-opening series of events, perhaps a game changer.

Recently, both NYU Medical School and Columbia Physicians and Surgeons have announced programs to offer (a) free tuition to all students regardless of need (in the case of NYU) and (b) full tuition scholarships  to those in greatest financial need, while others would get only grants, not loans, to make up their need (in the case of Columbia).

Tune in to my next article which will answer the question whether offering 'free' tuition is really a boon to ameliorating the crises facing traditional medicine today.

Sunday, September 23, 2018

Thomas Edison Rest Stop is Closed: Finding Comfort in New Jersey Two Years after my Sister's Passing

The Thomas Edison Rest Stop along the 
New Jersey Turnpike is closed for Renovations

Just a short two years ago, I was on my way driving down the New Jersey Turnpike to Southern New Jersey for the funeral of my sister Marilyn. 

Then, I passed many Rest Stops along the way including the Thomas Edison pictured above.

This year I was doubly sadly in shock on my way down the NJ Turnpike-- to spend Shabbat in a warm caring community to gain comfort and healing for sister Marilyn...

She was so abruptly taken from our family by a metastatic lung cancer. 

I  was preparing to exit the ramp to heed the call of nature and  quaff some Starbucks at the service area named for our  famous luminary (aka the 'Wizard of Menlo Park', NJ ) and, lo and behold, there appeared a sign declaring that this area had closed. 

It seemed so final to me, as if a light had been extinguished, sudden, unanticipated--reminiscent of the final days of Marilyn's precious life.  

Thomas Edison Library courtesy of Wikimedia  Commons  

(I had visited The Thomas Edison National Historic Park in West Orange, NJ many times and found Glenmont,- the family estate home-, his laboratories and his library fully intact as they were when he was still alive.)

This story, however, does have a happy ending.....

 It does lighten up. 

My weekend near Philadelphia was replete with much healing and uplifting of my spirit and that of my departed sister.

 My hosts made me feel at home for the second year in a row and the Synagogue provided me the opportunity to recite many kaddishes (memorial prayers) for her.

I even read a Mishna in her honor. 

When I returned home,  I googled the area and much to my de-light learned that the stop is temporarily closed for renovations and will reopen soon.



Friday, August 31, 2018

Stressed out medical professional trainees/students? There's a quiet poetic (R)evolution in the air

For five  earlier articles depicting how the medical arts have devolved, scroll through my blogs beginning with the seminal one entitled Crises in the Medical Arts: Returning Medicine to Patient Centered Care Giving.

The links between the healing arts and poetry are well known.

The Statute of Apollo Outside the National Academy of Athens
Apollo was recognized as the god of healing, poetry, music, truth,
the sun and light and much more  

 For instance,  poets including  John Keats, William Carlos Williams and Oliver Wendell Holmes, Sr.  all received medical education.

The composition, recitation and listening to verse is known to release pent up feelings of angst, sadness, sorrow and depression--making it much easier to deal with these stressful feelings. (this subject to be explored in a forthcoming article)

Perhaps one  of the most calming and stress- relieving poems  is Psalm 23 which begins with:
"The Lord is my shepherd I shall not want."

The verse soothes all those who are  stressed through life's  travails  with its lovely images such as  being lead beside still waters and being guided on the right paths,  though we walk through the valley of the shadow of death. 

So it comes as no surprise that poetry would be a tonic for the  proverbially overworked medical trainee.

Kudos to the pioneering steps of St. Andrews Medical School (founded in. 1413) that acknowledges the healing benefits of poetry and the practice of humanistic medicine.

Tools of the Trade is a pocket size 
book of collected poems for doctors, It is
small enough to pull out and read when needed
photo from the Scottish Poetry Library.

Each year, each of the circa 900 Scottish medical school graduates receives "Tools of the Trade: Poems for new Doctors."  It's a small volume, less than 100 pages--thus easily potable.

According to a recent Wall Street Journal article, "the poems are grouped into five themes designed to help young physicians: looking after yourself, looking after others, beginnings,  being with illness and endings."

May this project, though in its infancy, continue to blossom and spread the seeds of empathetic humanistic medicine.

Wednesday, August 22, 2018

204 year-old New Hampshire Country Store is Rescued

Francestown, New Hampshire Village Store
photo courtesy of the Monadnock Ledger Transcript 

Francestown, New Hampshire (pop. 1600) has a new hero.

He is Nevada resident William "Bill" Smith (along with his three daughters). 

After Bill read an article in the Wall Street Journal that the 204 year-old building was going to be sold at auction, he called the Town Administrator  and arranged a deal to pay off the mortgage and back taxes.

The store will be renamed the The Three Sisters Building in honor of his three daughters who attended the welcoming event in Bill's honor at the recently refurbished Francestown Town Hall. 

Image courtesy of The Francestown News

Kudos to the FIHS (Francestown Improvement and Historical Society) which has been organizing a series of events to raise funds for the interior renovation: BBQ's, potluck dinners and 5K races.
I wish to thank Rose and John Perry owners of the Inn at Crotched Mountain. They have been running ads in the Francestown News and I happened to pick up a copy at their inn.

The May, 2018 issue caught my attention with the front page bi-line Mr. Smith Comes to Francestown. (It was an obvious reference to the 1939 movie starring James Stewart as an idealistic freshman US senator.)

Hallelujah Mr. Smith.

Monday, August 20, 2018

What ever Happened to the Bedside Manner: New Directions to Empathetic Medicine

Just the other day, I chatted with an executive here in Connecticut about the near lack of patient centered medicine.

She couldn't have agreed any more with my sentiments.

Immediately, she alluded to a physician friend who teaches resident physicians at Yale New Haven Hospital.

What is novel in the latter's approach is this:  she accurately diagnosed a crying need.

She discovered what was lacking in her students as they interviewed patients on their diurnal rounds.

She found that students were solely focused on the specific ailment/condition confronting them, be it cardiac, neurological or pulmonary related.

All the while, they perfunctorily observed and tested only the malfunctioning system with little or no curiosity about the state of mind of their subjects. 

There was little or no attempt to make conversation. 

(What ever happened to the traditional bedside manner when the physician prided himself in connecting with his patient? Asking questions and listening carefully to responses)

And so she told them they were only getting a limited picture of their patient--kind -of- like taking a close-up facial selfie while ignoring the rest of the whole picture: chest, hands, arms legs,etc. 

So, she is now training her students to smile, look the patient in the  eyes and take time to establish a relationship  with the suffering patient through empathy to set the patient at ease. 

 She is thus  training her charges to to observe, to test and to diagnose the entire patient.

My next articles in this series will further explore what medical schools are doing to address this very important issue of bringing back patient centered medicine.

Thursday, August 16, 2018

Remembering Gerry Rhine 1938-2018

Yesterday, my friend Jerry Rhine was laid to rest.

Jerry was no ordinary friend. He was a special friend, who I got to know very well over the last 10 years.

As he spent the last two decades of his life battling numerous diseases, he turned to his creator to gain spiritual strength to fight back. And that he did nobly, with persistence, to the best of his ability.

He rarely spoke to me about his personal agonies , but he was a vocal advocate of the healing powers of visualization and positive thinking.

In 2014, Jerry published his book, Healing, about his personal experience.

Jerry, may your memory and your good deeds be a source of inspiration to all.

Tuesday, July 31, 2018

: Recreating the empathetic medical professional: The traditional long path to a medical career

For earlier articles in this series click here.

Setting empathy aside for a moment, let's peruse the journey and  the length of time it traditionally has taken for a physician to hang out his shingle.  

Consider this journey: 4 years of college, then 4 years of Medical School, followed by a year of internship and then a residency that could take 3 years for internal medicine and up to seven years for neurosurgery.

That's 12-16 years so far and still counting....

But training is not yet complete in many subspecialities. Joining or opening up a practice is further delayed by the need for more clinical experience to keep up with changes brought about by advances in technology.

After residency many newly minted physicians follow up with more training in a one or two year fellowship programs;  here they assimilate  more hands-on experience--in fields where technology is leading and pushing the boundaries of  operational techniques at a rapid pace. (particularly in peripheral vascular medicine)

Medical Path: image courtesy of Kaplan Learning Center 

The total commitment now stands at up to 18 years after High School ... which translates into nearly age 40.

Next take a deep breath.

, contemplate the financial burdens encountered along the way; many young doctors emerge the slog carrying a debt burden that  easily totals  hundred of  thousand  dollars.... 

In my next aritcle, I will focus on techniques that have been introduced in medical training to enhance student empathy.

So tune in!