by Anya Bourg
Narration:
At Mount Sinai Hospital in Manhattan it's business as usual. A typical examining room, sterile and bare, a doctor in a white coat strides in.
Tape:
Ambient sound of conversation between doctor and patient
Narration:
Today's conversation is difficult, but one that doctors and patients inevitably encounter. But this is no ordinary doctor and patient. It's actor Barbara Haas in the role of a middle-aged woman receiving the bad news that she has bone marrow cancer. The doctor is Kristy Giles, a third year medical student.
Tape:
Ambient sound of conversation between doctor and patient
Narration:
At the Morchand Center, actors play patients to teach medical students better communication skills. In addition to difficult conversations, the students practice performing physical exams and routine tests.
The actors feign symptoms, sometimes wincing and crying out in pain. The sessions are videotaped and the students are evaluated by professors as well as the actors, known as standardized patients.
Roxanne Rohan is a third year medical student who passed through the center last week.
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90% of a doctor patient interaction is either good or bad based on the communication that your doctor has with you. It is not about the clinical expertise as much as it is about how your doctor conveys confidence to you and instills confidence in you.
Narration:
It's more than just a warm and fuzzy relationship, knowing how to talk to patients means knowing what questions to ask and allowing patients to feel comfortable revealing the intimate details of their symptoms. And it impacts whether patients follow their physician's advice and take their medicine.
Dr. Greg Carroll is the Executive Director of the Bayer Institute, one of the leading research and training centers that teaches doctors to look, listen, and learn.
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In the typical primary care visit, most patients from the time they open their mouth until they get interrupted the first time only get to talk for somewhere between 18-23 seconds, that often speaks volumes to them about how they are supposed to conduct their communication for the rest of the visit.
Narration:
Some say the trend to improve communication between doctors and patients takes its tune from the business world's attention to consumer satisfaction. But whatever the cause, with patient's complaints about managed care and dispassionate and harried doctors, facilities like the Morchand Center have sprung up in 95% of medical schools. And this year all medical students across the country will be required to pass a new clinical skills test as part of the rigorous exams that medical students undergo. Dr. James Thompson is President of the Federation of State Medical Boards.
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We now have following 20 years of research in our Nations Research institutions that are a valid reliable and fair examination, that assures the public that anyone entering the profession will meet the same skill and knowledge of medicine no matter where they are educated.
Narration:
The exam is designed to reflect a typical doctor's workday, student's will spend a full day meeting with 10 standardized patients, actors, like the one's at Mount Sinai. They will conduct physical exams, record information, and make follow-up plans.
The National American Medical Association however has come out against the exam because they say there is no evidence that the test will weed out bad doctors and not just some doctors. David Rossman is on the board of Trustees at the NAMA.
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There is no demonstration that the physicians who are taking this exam or have failed this exam are any worse than physicians who have passed the exam. It could result in a decrease of access of care to the public if physicians are weeded out and unable to o btain liscences.
And while everyone agrees that poor communication is poor medical practice, medical students are against the test as well.
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I think its a financial burden for us.
That's Catherine Kronk, a medical student and the co-president of the American Medical Student Association at Columbia University.
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1:00 There are only 5 sites across the country so it can cost you up to 2000 dollars to go take this clinical skills assessment exam, which is critical skills, but it is a burden of both time and finances for students.
Narration:
Despite the controversy, come June, the exams will begin nationwide.
For Columbia Radio News, I'm Anya Bourg