Berks County Medical Society Medical Record Winter 2021 - 20

More Humanities in Medical Education
continued from page 19
States spends double the median expenditure of the most advanced
countries in the world and yet our health care data shows us, at
best, to have median outcomes and in some categories to be near
the bottom in outcomes. On several occasions I have asked groups
of residents what the hospital charges for a CT scan or an MRI.
Invariably I have been met with vacant stares. One has to know the
cost in order to determine cost effectiveness. As systems begin to
demand more cost-sharing with patients, patients will and should
demand our awareness of the costs of different clinical alternatives.
We also have an obligation to teach residents how to manage their
personal economics, current debt and--hopefully--future assets.
10. History of Medicine: " History always acts as an umbilical
cord of human civilization. Days of yore have always answered the
bewildering paradoxes and enigmas of the world. So, it's always
better to have a glance of the past before entering any uncharted
territory. " - Ramkrishna Guru
" Tomorrow was created yesterday.......And by the day before
yesterday, too. To ignore history is to ignore the wolf at the door. "
John le Carre, A Most Wanted Man.
I have found residents and others to be amused by some of
the history of medicine and in need of being reminded that future
physicians might be amused by us. Knowledge of history informs
current decision making in all fields.
11. Medical Liability: Patient safety and physician
accountability for our maintaining a standard of care are legitimate
societal and physician goals. However, the past 30 years has seen
peaks and valleys in the aggressiveness of patients and attorneys in
seeking those goals, such that physicians are challenged to protect
an emotional equilibrium necessary for good patient care and an
economic equilibrium necessary to afford practicing. We need to
understand how to protect patient safety, remain accountable, and be
prepared for the next cycle of medical liability.
Have we missed important elements? Are there some listed
that are not " humanities " , dilute the others and should not be
part of the curriculum?
How, Who, When will we deliver a Medical Humanities
Curriculum
How
It is anticipated that the curriculum would be an expression of
the diversity in our community rather than a cohesive, standardized
form and format. Consistent with goals and objectives, yes; but also
amenable to creativity in terms of material presented, by whom it is
presented, and in what manner it is presented. Goals include:
1. Art, Music, and Poetry should be prominent throughout
the curriculum. Healthcare-focused art is quite abundant. Museum
tours, evenings of music related to the history of medicine would be
wonderful adjuncts to the curriculum.
2. Heightening compassion and understanding should be
considered by the " shepherds " of each topic.

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3. Finding joy and fulfillment in practice while recognizing
that the loss of control is suffocating should be considered by the
" shepherds " of each topic; with a goal of avoiding burnout.
4. All modalities should be considered: small groups, dinner
meetings, in system videos for program or library use, commercially
prepared material. Goals should include developing the modality
that best suits the material, educational efficiency (interactive
learning, using proven effective teaching techniques, minimizing
PowerPoint presentations) and reaching the greatest number of
physicians in our community. There will be a steering committee
that will seek funding and then will need to contain the curriculum
within a budget.
Who
Hopefully, the Who will be an expression of the diverse talents
within our community. There really is no reason to even limit it to
physicians. We are thinking of having 3-4 " shepherds " to develop
each topic. Some should have knowledge of the topic. Others might
have experience in teaching and only interest in the topic. We will
need BOTH for each topic. We also hope that the shepherds will
be the role models for finding joy and fulfillment in this project,
getting enjoyment by taking part in a project designed to increase or
re-discover the humanity in medicine! More than anything we need
people who have the ability to look up rather than down! We might
allow support from industry, but will be excruciatingly careful to
avoid conflicts of interest.
We recognize the value of bringing physicians from throughout
our system(s) together and also bringing residents, attending
physicians, and faculty together. We also recognize that for some
topics small group discussion might best be peer group rather
than non-hierarchical. We want diverse knowledge, geography,
backgrounds, cultures, genders! Diversity is central to Humanity.
Will you be a part of this project?
When
It is the general consensus, thus far, that each topic will require at
least two sessions during each iteration of the curriculum. Program
Directors have suggested that they could find the availability of at
least one session monthly for items in the curriculum. Thus, the 11
items or 22 sessions, each once monthly, would result in a two-year
recurrent curriculum. When it would start depends on the interest
that you, the reader, demonstrates.
I hope you are excited and believe this venture is worthwhile.
Regardless of your knowledge or talent in any of the areas, if you
would like to participate, please contact us! We welcome all of your
comments!
Peter A. Schwartz M.D.
schwartzpa@hotmail.com
610 780 0845



Berks County Medical Society Medical Record Winter 2021

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