The culture of medicine

December 31, 2008

Waltham, Mass.--Everybody is familiar with the stereotypes of medical education from the student perspective: grueling hours, little recognition, and even less glory. Now a novel Brandeis study published in Academic Medicine this month pulls back the curtain on the dominant environment of academic medicine from the perspective of faculty, the providers of medical education in medical schools.

The study raises questions about how the prevailing culture of academic medicine shapes the delivery of healthcare--from the quality of patient care and physician professionalism, to faculty burnout and leadership opportunities for women, minorities and primary care physicians. The article reports on how medical faculty experience the culture in which they work by examining their relationships to each other, to medical students, and to patients, as a reflection of the broader environment within academic medicine.

Brandeis University senior scientist Dr. Linda Pololi and her colleagues conducted in-depth one-on-one interviews with faculty members in a variety of specialty areas at five prominent medical schools across the country. While the study determined that positive relational aspects of the culture in academic medicine exist, it found that faculty often experienced disconnection, competitive individualism, undervaluing of humanistic qualities, deprecation, disrespect, and the erosion of trust.

"These negative experiences are undermining the central task of medical schools pointed out by the Pew-Fetzer Task Force in the 1990s, to help students, faculty, and medical practitioners to form caring, healing relationships with patients and their communities and with each other," said Pololi.

The study found that serious problems exist in the relational culture affecting medical faculty vitality, professionalism, and general productivity, and are linked to retention. "These aspects of the culture undermine the goals of medical institutions and are antithetical to fostering superior patient care, biomedical research, and educational excellence," explained Pololi. "It is highly laudable that the deans in our participating schools have taken this trail-blazing initiative to explore the extent and causes of this dissatisfaction and to do something about it."

The implications for healthcare are significant. "We have the most technologically advanced and most expensive medical system in the world, but we need compassionate healthcare as well," said Pololi. "We cannot teach compassion for patients without practicing it among ourselves; we cannot learn to be sensitive to cultural diversity in our patients without incorporating the perspectives of women and minority physicians who make up a larger portion of the medical workforce than ever before. We cannot be optimally successful in researching the causes of disease and finding new treatments without rewarding collaboration and openness, rather than competitive individualism."
-end-
The study, funded by the Macy Foundation, is part of an ongoing project, the National Initiative on Gender, Culture and Leadership in Medicine, known as C - Change. The project seeks to address the imperative of developing women and minority faculty members' full potential and leadership in academic medicine in the U.S. The deans of these medical schools have teamed up with the research group to take on a leadership role in addressing what are national problems.

Brandeis University

Related Healthcare Articles from Brightsurf:

How to protect healthcare workers from COVID-19
Researchers are developing simple and inexpensive tools--like a DIY ventilator--to treat patients more effectively and prevent disease transmission in hospitals.

Healthcare as a climate solution
Although the link may not be obvious, healthcare and climate change -- two issues that pose major challenges around the world -- are in fact more connected than society may realize.

Healthcare's earthquake: Lessons from COVID-19
Leaders and clinician researchers from Beth Israel Lahey Health propose using complexity science to identify strategies that healthcare organizations can use to respond better to the ongoing pandemic and to anticipate future challenges to healthcare delivery.

Poor women in Bangladesh reluctant to use healthcare
A study, published in PLOS ONE, found that the women living in Dhaka slums were reluctant to use institutionalised maternal health care for fear of having to make undocumented payments, unfamiliar institutional processes, lack of social and family support, matters of honour and shame, a culture of silence and inadequate spousal communication on health issues.

Women and men executives have differing perceptions of healthcare workplaces according to a survey report in the Journal of Healthcare Management
Healthcare organizations that can attract and retain talented women executives have the advantage over their peers, finds a special report in the September/October issue of the Journal of Healthcare Management, an official publication of the American College of Healthcare Executives (ACHE).

Greater financial integration generally not associated with better healthcare quality
New findings from a Dartmouth-led study, published in the August issue of Health Affairs, show that larger, more integrated healthcare systems do not generally deliver better quality care, and that there is significant variation in quality scores across hospitals and physician practices, regardless of whether they are independent or owned by larger systems.

Wearable sensor may help to assess stress in healthcare workers
A wearable biosensor may help monitor stress experienced by healthcare professionals, according to a study published in Physiological Reports.

Healthcare innovators focus on 'quality as a business strategy' -- update from Journal of Healthcare Quality
Despite two decades of effort -- targeting care processes, outcomes, and most recently the value of care - progress has been slow in closing the gap between quality and cost in the US healthcare system.

How runaway healthcare costs are a threat to older adults and what to do about it
Empowering Medicare to directly negotiate drug prices, accelerating the adoption of value-based care, using philanthropy as a catalyst for reform and expanding senior-specific models of care are among recommendations for reducing healthcare costs published in a new special report and supplement to the Winter 2019-20 edition of Generations, the journal of the American Society of Aging (ASA).

How can healthcare achieve real technology driven transformation?
Real transformation in healthcare through the adoption of artificial intelligence (AI), robotics, telecommunications, and other advanced technologies could provide significant improvements in healthcare quality, productivity, and access.

Read More: Healthcare News and Healthcare Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.