Program to Close Gap between Thinkers, Doers
The gap between thinkers and doers is sometimes a wide one.
If philosophers are the thinkers and physicians are the doers, can their polarized positions meld to produce a thinking doer? More practically, can medical educators aided by humanists, produce a physician who treats more than the disease -- one who treats the whole person?
This is the crux of a new program on medical humanities, headed by MSU’s long time Dean of the College of Human Medicine, Andrew Hunt.
Officially approved by the Board of Trustees in September, the fledgling formal program is based on an approach to medical education that has been in the informal seminar-discussion-study stage at the University for several years.
Its proponents believe that medicine is one of the humanities. In a small, but growing national trend, educators are beginning to look at the totality of the education a medical doctor receives and the subtleties that should be included in that education.
MSU’s earliest plans for the College of Human Medicine emphasized a multidisciplinary approach to medical education, the core on which the new program is based. Hunt calls the interdisciplinary effort “an almost characteristic Michigan State way. At Michigan State,” he says, “we have fairly low department barriers -- a long history of easy collaboration.”
But Hunt himself confesses a little surprise at the early innovative plans. “They were talking about utilizing the existing departments of anatomy, physiology and biochemistry which were already here for vet medicine,” Hunt says, explaining that medical schools normally have their own departments in these areas.
“This was very innovative at the time,” he continues. “Actually, it was a little scarey because it was so new, but President Hannah was very dynamic and compelling -- and it was going to work.”
Hunt’s inclinations were the same as Hannah’s, however, and when he found that the behavioral sciences were interested in participating in the same ways as the biological sciences, he remembers, “I made it almost a condition of recruitment that I'd come if they would add these (anthropology, sociology, psychology) to the pre-clinical 2-year program.”
The curriculum of the college from the beginning was more related to social needs Hunt says, and in the process of its formation, innovative faculty and students looking for this approach were attracted.
About four or five years ago, Hunt says, MSU faculty began to get interested in some of the issues being talked about nationally -- issues he calls “really enormous.” He lists “obvious ethical decisions and serious technological problems, the life and death of mentally deficient infants, old people kept alive by machines.
“There’s a whole area of informed consent,” he continues, “doctor-patient relationships, respecting the feelings of the patient which we haven’t done very well in the past, ethics of research programs, ethical issues of controlled experiments on human subjects, public policy issues like abortion, and so on.”
“During that period, Martin Benjamin, associate professor of philosophy and his departmental colleagues began holding ethics conferences in area hospitals,” Hunt says. A medical student on campus, Howard Brody, became well known nationally with his deep involvement in the expanding informal medical humanities program. “Potchen came,” Hunt says of James Potchen, chairman of radiology, “and he was interested in it and it was under his department’s aegis that the evening seminars on the subject of medical humanities began.”
Now after two years of these multidisciplinary seminars which have created a growing interest among students and other faculty, came the formalized program “complete with coordinator, an office and an account number,” says Hunt.
The changes planned for this year are minimal. “We’ll continue much the same this year,” Hunt says. “We will try to create a policy board, with representation from the colleges of medicine, nursing, University College, arts and letters, the Honors College and others.” The evening seminars and ethics conferences will continue.
But as the years progress so will the emphasis on humanities in training physicians and Hunt believes that other disciplines will benefit from their involvement in the process.
Potchen, a firm believer in “treating the sick people instead of their diseases” says “one thing we've never done is to effectively crystallize a lot of the resources of this institution to bring to bear on problems in medical education.
“Of all the institutions I’ve been in, this institution has the biggest chance of pulling off the big difference,” Potchen says.
Hunt believes that this sharing of the medical student’s education can offer shadings to doctors not previously experienced.
“Philosophers approach problems in a different way,” he says. “In a scholarly way, they understand the history, human thought, the logic and morality of a subject. They argue conceptually about problems and disagree violently with each other, but still maintain respect for each other,” he says. “They dissect issues logically, which physicians just don’t do.”
Hunt says the medical profession is in trouble with “what looks like greed . . . with what looks like callousness . . . with what looks like a very conservative political position.”
His idea is not to basically change the doers that physicians must be, but to tone them with colors from the humanists and to offer them culture within the medical school
complex. “Medical school has a way making people into terrible drudges and that isn't what we want,” he says.
If this humane approach to educating a physician is working or will work Hunt doesn't know. “Whether it really makes a measurable difference, in our graduates, I don't know, but we can really get our faculty thinking in these kinds of terms and imparting them to students.”
“Somehow it’s bound to make a difference.”
The next evening seminar is tonight (Thursday, Nov. 10) 105 Kellogg Center. Hunt and Harold Blumenstein, Bay City radiologist, will speak on “The delivery of health care: physician’s, patient’s and society’s rights.”
-- JANICE HAYHOW
Michigan State University News-Bulletin
November 10, 1977