As engagement with the electronic medical record has taken time away from bedside interactions in medical education, rheumatologist Jason Liebowitz wanted to capture a crucial aspect of training that he sees, sadly, diminishing — the wisdom and insight gained from working with master clinicians.
“There’s only so much you can gain from reading a standard textbook about clinical excellence or clinical reasoning. It doesn’t really convey what you get when you have the opportunity to work in-person, one-on-one with a true master clinician,” says Liebowitz, who completed his residency and fellowship training at Johns Hopkins and is now an assistant professor of medicine at Columbia University Irving Medical Center.
In an effort to convey these invaluable lessons in clinical excellence — on topics ranging from patient communication to mentorship to burnout — Liebowitz, along with Johns Hopkins rheumatologist Philip Seo, Lowe Family CIM Scholar, and Marcy Bolster of Harvard Medical School and Massachusetts General Hospital, solicited and edited a collection of 25 introspective essays from an interdisciplinary group of master clinicians who are also compelling writers. The result: Masterclass in Medicine: Lessons from the Experts.
Seo was Liebowitz’s fellowship program director at Johns Hopkins; the two first met when Liebowitz was in his residency. Both Johns Hopkins and CIM are well-represented among the group of authors, who weave together foundational stories from their own educations and careers.
CIM Director David Hellmann opens his chapter, “Partnering with Patients,” by retelling the time during his first year of residency, when he witnessed another physician pull a diagnostic rabbit out of the hat by asking the patient what the patient thought was causing the mysterious, multisystem illness that had stumped a team of doctors. The patient’s suspicion — that it was the fungal infection coccidiomycosis, borne from spores found in desert sand — turned out to be true. A truck driver, the patient had picked it up after driving through the California desert, and had recently read about truckers developing Valley Fever, another term for the condition. Hellman goes on to say that partnering with patients has “helped [him] become a better healer and added immeasurable joy, satisfaction, meaning, and wonder to [his] professional life.”
“Medicine is the most wonderful career in the world, and getting to know the patient is the most wonderful part of the practice of medicine.” – Roy Ziegelstein, vice dean for education, writing in Masterclass in Medicine
Roy Ziegelstein, vice dean for education at the Johns Hopkins University School of Medicine, contributed “Personomics,” a chapter on the term he coined that brings together the information physicians need to know to provide individualized care — the “psychological, social, cultural, behavioral, economic and unique life circumstances,” he writes. “Medicine is the most wonderful career in the world, and getting to know the patient is the most wonderful part of the practice of medicine.” He recalls the moment from his first year of medical school in which the concept was born, when a pupil asked if he’d rather be a technically skilled doctor or one who knew the patient well as a human being. He realized he didn’t have to choose one or the other.
Seo points to Suzanne Koven ’86, an associate professor of medicine at Harvard Medical School who was an assistant chief of service in the Osler Medical Residency, who explained in a recent authors chat what unites the writers of the book.
“She said what everyone had in common was the love that they have for their patients, the love that they have for learning, the love that they have for their colleagues — that all of them brought their love to the profession, and that’s what drives them forward,” he says. “Even though we, from the outside, think of them as masters, they are still learning eagerly from each other.”
Liebowitz hopes medical students and young physicians read the book to get the kind of bedside wisdom they might be missing.
“We want someone reading this book to feel like they’re having a conversation with these great doctors.”
