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Carrie C's avatar

Excellent and relevant essay.

This sentence stood out to me: “This creates doctors who are constantly striving to reach perfect “quality metrics” without ever questioning why patient outcomes are not improving.”

Not improving because (as an example) at my main work environment- skilled nursing facilities, one will see mostly patients with chronic disease such as cellulitis, CHF, DM, PVD, multiple joint replacements and back pain but no one ever addresses the root causes and does one thing to address them. Instead the boxes are checked that the infection was cleared or the pain is improved with gabapentin or this morning’s finger stick was normal. And the patient often returns 4 months after discharge for another stay to address those same issues.

Students in medicine are taught to recognize the tree but not see that the forest is burning down around it- and to do something about it.

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Ernest N. Curtis's avatar

Lots of good points in this article. But I think that medical school is a little late in the educational process to be learning critical thinking skills. The failure to develop this mode of thought is largely the fault of the entire educational system. The devolution of the culture with the deliberate attack on the institution of the family probably plays a role as well.

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