'Hidden' med school curriculum hurts empathetic care

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With April research showing medical interns spend very little time directly caring for patients, medical education is getting more bad press.

Danielle Ofri, M.D., Ph.D., an associate professor of medicine at NYU School of Medicine, exposes the darker side of transitioning from the classroom to clinical medicine--students come in selfless and empathetic and leave jaded and embittered.

Empathy and moral reasoning begin to erode during the third year of medical school, with students daily witnessing both patients and doctors experience fear, anger, grief and humiliation, Ofri wrote in Slate.

Medical students also learn the "hidden curriculum," in which they observe healthcare hierarchies and bureaucracies in action, efficiency take precedence over patient care, and a hypocrisy of doctor-patient communication and bedside manner, according to the article.

Such was the case for a young medical student who, reflecting on his first clinical rotations, observed practicing physicians don't seem to care about patients anymore, noted Carla Rotering, Hospital Impact blogger and pulmonologist at Banner Thunderbird Medical Center in Phoenix. The culture of medicine is shifting in intensity, demand and autonomy, making caring less visible to patients, Rotering wrote last month in a Hospital Impact blog post.

But medical schools are implementing efforts to thwart misery and cynicism in future doctors, such as consistent mentorship and earlier clinical exposure, according to Slate.

Medical educators are realizing the loss of empathy can hurt patients and hospitals' bottom lines. In fact, research shows more empathetic physicians achieve better clinical outcomes. With that in mind, hospitals including the Cleveland Clinic are making empathy an important part of patient experience efforts and quality initiatives.

To learn more:
- here's the Slate article
- read the blog post

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