Putting the Patient Back Into Medicine

When Martin A. Samuels was growing up in the suburbs of Cleveland, a house call from his pediatrician J.W. Epstein was a big deal.

Samuels says his mother would make him take a shower and put on new clothes while waiting for Epstein’s old jalopy to come up the drive.

Whether Samuels was suffering from measles or the chicken pox, Epstein was always gentle and reassuring. “It was a very romanticized version of what a doctor was supposed to be,” says Samuels.

“I asked him one day, ‘Can you continue to take care of me now that I’m not a child anymore?’ and he replied, ‘I’ll take care of you until you’re a doctor’” recalls Samuels—now chief of neurology at the Harvard-affiliated Brigham and Women’s Hospital.

For Samuels, Epstein was an ideal physician—skilled in both the scientific and the humane, interactive aspects of medicine.

But that model, he says, is fast disappearing as schools and hospitals increasingly prioritize teaching new medical technologies and clinical guidelines.

Such “evidenced-based” training has been a boon for medical care in a technical sense. But Samuels and colleagues like Medical School associate professor Katharine K. Treadway, who teaches a class at the Medical School called “Introduction to the Profession,” say they worry that the physician’s traditional focus on doctor-patient relationships has been lost amid the shuffle.

“What we don’t do enough of is helping students not just to make a diagnosis and not just to think about the treatment but also to think about what the experience is for the patient in terms of what I’m doing and what I can do to help,” Treadway says.

‘INSPIRED TO ACT’

In an effort to inspire physicians to internalize traditional values of medicine, Samuels used an old form of technology—the radio—to launch a program entitled “Inspired to Act.”

He helped develop the weekly XM Satellite Radio broadcast to highlight more personal aspects of medicine as a response to the heightened pressures doctors face today. Each week, Samuels chats with a guest picked because they “have done something inspiring in medicine,” such as improving clinical care in third-world countries or performing the world’s first kidney transplant.

“It’s just a fascinating program,” says Allan H. Ropper, who helped found the field of neurological intensive care and now serves as executive vice chair of neurology at Brigham and Women’s.

Ropper, who was featured on a segment about the traditional values of medicine, said he believes these values are “immemorial.”

“They revolve around putting the patient first, relieving their suffering,” Ropper says.

What has changed, he says, is how patients are treated.

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