A premed student comes to you for advice. She’s read that by the time she finishes medical school and residency, there is a 50% chance she will feel emotionally exhausted, socially isolated, and like she is not doing a good job. But she still wants to be a physician.
“What advice would you give her?” asks Stephen Swensen, Medical Director for Professionalism and Peer Support and Intermountain Healthcare.
“What I’d tell her, honestly, is, ‘pick the right system,’” says Brent James, Vice President and Chief Quality Officer for Intermountain. “There are some places out there who understand those questions and build a clinical environment that will completely reshape her experience.” The practice of medicine today is so massively complex that you cannot succeed at it as a standalone individual, says James. “You’re always going to be effectively part of a team. So find a good team. Find a good team that knows how to manage clinical knowledge. If you get that right knowledge management running, you see that’s what that little protocol does.”
The protocol James describes is the electronic medical record. While he feels the current EMR is a failure, he believes it’s an interim one. The next-generation EMR is on the horizon, he says, which should understand clinical knowledge as its primary goal and do the “scut work,” leaving you free to be a physician. “I can make you not just a far better physician, I can make your professional life beautiful,” he says. “Now I realize that that medical student is not going to be able to create that. We’re [health care leaders] the guys who create that. That’s our job.”
“We’ve missed out, with some exceptions, on team alignment around care systems, residency training programs, [and] medical school,” adds Steven Strongwater, President and CEO for Atrius Health. “That linkage is not as tight as it ultimately needs be, and I think the bridge in some ways is making sure that you have your own personal mentor and educational plan.” Medical students can sometimes get caught up in the demands of learning and the emotional stress of dealing with patients, says Strongwater, and they need someone to help them get through that. “To a large extent I think it has to be a more integrated curriculum, and then that student needs some help going along.”
From the NEJM Catalyst event Physicians Leading | Leading Physicians at Intermountain Healthcare, July 12, 2017.