Understanding why

DB,

I do not know how to approach the why from a teaching standpoint. However, from my experience in the military, in the pharmaceutical industry, and in the nuclear industry–all bureaucratically regulated like the medical industry–I have found a dearth of people who appreciate the why questions. What is truly disheartening to me is when I ask why, or similar questions, I get labeled a seditious character.

As you can well understand, I am sure that the reasons for eschewing questions of why are numerous. However, when we are given the professional title of doctor, and afforded a professional privilege, I believe we should be masters of the philosophy, a PhD in pathophysiology, pharmacology, and procedures. But, even my classmates do not see their medical education as such. I do believe much of the forest has been lost for the trees.

But, I also believe that it ain’t like it used to be and never was. We should teach for understanding, not memorization. That’s where you get to be able to answer the why.

I agree, why should you be recognized for doing your job right? It should be the “normal” expected thing to do right? WRONG. I’ve never seen such an epidemic of qualified fruitful docotors,lawyers, nurses and judges who go on to merely “instruct”. Instruction has become something to “get out of the way” to permit time to move on to the other things. That is why you were recognized. Because you actually took the time necessary to investigate, evaluate and understand your craft and talent. You’ve opted to actually teach for understanding and not for the chance to get a decorated lab coat. You have every right to feel the way you do, because it’s shocking, but not new. So much money spent on education, yet no one is being educated. That’s the reason why Mal-Practice lawsuits came into existence. Cheers-Janine S.D, CA

Too many attendings I worked with didn’t know why; or they couldn’t explain it.

To many residents I worked with didn’t care why – they already had their fellowship slots.

High quality patient care is time consuming, stressful and labor intense. It occurs when the pt needs the care and is hard to plan around conferences, constant pages, family meetinings and reems of paperwork.

It’s even harder to pull off if you’re supposed to be in the lab running gels…

Attendings who can explain the rationale behind the treatment are rare. Those who actually want to teach (as opposed to those being force to round with a team) are rare.

Those who tell their students to “prepare a talk on this topic for tomarrow” instead of answering a question are part of the problem, not part of the solution.

There has been a change in medical education recently. Ten years ago the idea was “you get out of your education what you put in to it; nothing more.”

Now medical education is supposed to be a passive process where “the learner” simply absorbs information without participating in the patient care, the workup, teatment or discussion of the patient.

Perhaps that is why excellence in teaching is so rarely recognized or rewarded appropriately.