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Tuesday Jan 05, 2016

Looking for a Hero: Kids Need Medical Role Models

One of my community's elementary schools invites local professionals in every Friday to speak about their jobs and answer kids' questions. Although the program is designed primarily to introduce children to varied professions, it also serves as an introduction to local professionals and possible mentors. Student attendance is voluntary, so those who participate show interest, even if they don't all ask questions.

The school recently invited me to speak to a group of fourth- and fifth-grade students about being a physician. There were the typical questions about salary and education. They asked about other specialties and allied health professions such as physical therapy. But many questions focused on specific diseases or disorders. Multiple students asked about problems facing their families and friends. They asked about pneumonia and other infections. They even asked about medical anomalies they themselves faced. 

Although health professionals are concerned about the Health Insurance Portability and Accountability Act and privacy rights, these kids weren't worried about who knew their problems. The students just wanted to know as much as possible about the challenges they face.

As I discussed health issues such as abscesses and broken limbs, I realized how little education some of these students had received about even the basic functioning of the body. Although they all seemed to grasp the answers I gave, each question led to many more, and we had to limit ourselves somewhat because of the time we had available.

And then it dawned on me. They -- just like their parents -- are victims of the same time constraints placed on primary care physicians. Likely, these children have never had the opportunity to ask their questions in a comfortable setting. Much like the five-minute office visits that have become all too common, there had been no time for these young minds to be curious without an agenda. We fill up our days with curriculum and planning, both in and out of the classroom. We've sacrificed the time to be curious.

We as physicians serve a hugely important role as educators. This knowledge we gained is not to be hoarded, but shared. Inherent in our job description is arming patients with appropriate knowledge and preparation. Too often we can choose the easy path of "do it because I said so," whether because of time constraints or our own limited understanding, but we owe it to our patients to equip them to deal with their maladies.

In multiple languages, the word for doctor and the word for teacher derive from the same root. Traditionally, medical knowledge was passed from one teacher to only a single or select few apprentices. The traditional Hippocratic Oath even begins with the following passage:

"I will reverence my master who taught me the art. Equally with my parents, will I allow him things necessary for his support, and will consider his sons as brothers. I will teach them my art without reward or agreement; and I will impart all my acquirement, instructions, and whatever I know, to my master's children, as to my own; and likewise to all my pupils, who shall bind and tie themselves by a professional oath, but to none else."

Teaching persists as an integral part of medical education and practice. From our first days as medical students, we are indoctrinated with the directive "See one, do one, teach one." Inherent in this phrase is the message that teaching someone a skill ranks equally in importance with the ability to perform the skill ourselves. Teaching the details, preparing for questions, and cultivating the ability to adequately communicate the intricacies of even the simplest procedures or concepts requires a high level of understanding. This includes the education of not only students and residents, but of our patients, as well.

Much like the students with whom I conversed, many patients are innately curious about their disease processes. We must take care not to stifle that curiosity but devise innovative ways for teaching and fostering education within the bounds of the current system. Although time constraints and economic concerns dictate parts of our practice, we must keep looking forward to better systems that will eventually replace the broken pieces. Whether through social media, group classes or some fledgling technology such as augmented reality, we need new tools for education and sharing information.

Education researchers in the 1950s demonstrated a correlation between increased curiosity and improved learning and retention. Think about the things you recall even after decades have passed. Nearly all of them relate to things that piqued your interest. I grew up watching scientists like Mr. Wizard and Bill Nye the Science Guy conduct experiments on television. I had teachers and physicians who taught me about the world around me and inside me. Without access to those individuals, I may have chosen another career path entirely.

One oft-proposed solution for physician shortages centers on starting recruitment and increasing student interest early in the education process. With the growing interest in science, technology, engineering, art and mathematics(www.slate.com) (STEAM) education, there has never been a better time to begin introducing medicine, especially the concept of whole-patient primary care -- family medicine -- to the next generation. Why not strike when naturally curious students are looking for answers? We need science heroes like the athletes and media personalities that our children often idolize.

We have thousands of well-qualified, intelligent physicians in communities across the country who appear ready and willing to lead that charge. AAFP President Wanda Filer, M.D., M.B.A., for example, has appeared on The Dr. Oz Show twice in the past nine months, discussing the importance of primary care and the dangers of prescription drug abuse. Regardless of what you think of that particular venue, there's no denying the fact that the platform allowed her to reach millions of viewers with those key messages.

We can talk to our young patients about their career goals and interests, but we also can look for broader opportunities in our local schools and through groups like the YMCA, Boys and Girls Clubs, etc. Physicians are in a unique position to be an inspiration for not only the young people we see, but also for patients of all ages. We can encourage their curiosity and give them tools they need to succeed and lead healthy lives.

Do you have suggestions or stories about how you've included education inside or outside your practice? Sound off in the comments below.

Gerry Tolbert, M.D., is a board-certified family physician who practices in northern Kentucky. A lifelong technophile, his interests include the intersection of medicine and technology. You can follow him on Twitter @DrTolbert(twitter.com).

Posted at 01:14PM Jan 05, 2016 by Gerry Tolbert, M.D.

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