Med schools must emphasize communication

Regarding “Med schools weak on instilling patient-safety skills, Leape report says”:

I have spent the past 10 years evaluating the frequency and effect of disruptive physician (and nurse) behaviors and their negative effect on communication, staff relationships, and clinical (quality and safety) outcomes of care.

In looking at the causes of why people behave the way they do, I looked at the contributions of age, gender, culture and ethnicity, family upbringing, life experiences and personality. But the biggest contributing factor to disruptive behaviors and poor communication skills is medical school training.

On day one students are hazed and ridiculed about what they don't know, which leads to low self-confidence and esteem. They become isolated and learn to function independently and later on become very dominant, authoritative and almost bullying as they take charge of patient care. The focus of learning is on technical and knowledge competency.

Their mentors perpetuate the situation. All these underlying factors are the antithesis of good communication and collaboration skills. With the growing complexity and stresses in today's healthcare environment, we need to re-energize the passion of being a doctor much of which is communicating and collaborating with patients and peers. This needs to start in medical school.

Alan H. Rosenstein, M.D.

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