Brimming with health reform initiatives, the College prides itself as an agent of change in the health policy arena. In particular, the Dartmouth Institute for Health Policy and Clinical Practice endeavors to increase the accessibility, affordability and accountability of health care delivery in the United States. From the comprehensive Dartmouth Atlas research to the advent of accountable care organizations, our College on the Hill develops creative solutions to our toughest health systems problems.
In conjunction with the Obama administration’s health care vision, directors and researchers at TDI have sought testing grounds for their proposals. Various hospitals and medical practices throughout the country have served as guinea pigs for the accountable care model, but what about in Dartmouth’s own backyard?
Within the undergraduate microcosm, conditions are ripe for health reform. Given the grim state of the College’s health services center, Dick’s House, and the lack of humanity in the premedical curriculum, Dartmouth should heed its own advice. After all, charity begins at home.
Notorious for lengthy wait times and inadequate care, Dick’s House causes more headaches than it cures. Criticisms of Dick’s House run the gamut, from shallow the unwelcoming, dilapidated interior and remote location to deep the unaccommodating appointment hours and the one-size-fits-all practice of medicine. Too often, sick students patiently sit through a cursory appointment, only to be shooed out the door, useless medical information memo in hand. The overabundance of nurse practitioners on staff relative to physicians results in insufficient textbook diagnoses. Absent are a patient’s bill of rights, tailored medicine and genuine patient-centered care, three tenets of TDI’s health reform strategy.
On the curriculum end, Dartmouth could shape up. By emphasizing patient-centered care, TDI aspires to train physicians to meet the medical, technological and empathetic demands of the future. Although medicine changes rapidly and broadly on the provider’s end be it technique, procedure, drug or practitioner the receiver of health care remains the same: a human being. The spirit of empathy is necessary to deliver health care effectively and accurately. But how well does the College fare in preparing premedical students to serve humbly as guests in the lives of patients?
Premedical school requirements are sometimes viewed as hurdles to jump through in order to achieve glamorous ends such as the title “Dr.,” the prestigious white lab coat and the high compensation. The true charge of medicine, an overwhelming desire or calling to help and heal others, is often sidelined in favor of securing high GPAs and checking off prerequisites. I realize these are unavoidable components of getting into medical school, another stepping stone. Yet at what point does neuroticism surrounding grades and social isolation inhibit the human face of medicine?
Introductory science and math courses sterilize the humanity of the medical profession. Though prospective medical students must firmly grasp rote knowledge, premedical courses should not be dismissed as means to an end; rather, the twin souls of medicine its art form and its scientific form should be emphasized and appreciated in tandem.
Don’t get me wrong. I have the utmost respect for my peers who dedicate themselves wholeheartedly to their premedical courses. I understand that what keeps these students going is unparalleled motivation to make the world a better place. It just seems that Dartmouth’s premedical curriculum is better at training physicists, not physicians.
Why are ethics courses not required? What about public speaking courses to improve patient-doctor interaction? Emotional and social psychology courses to raise the empathic meter of prospective doctors? Instead, basic sciences dominate. Just as Dartmouth pioneers national health reform, so, too, should it spearhead medical curriculum reform. The modifications to the 2015 Medical College Admission Test reflect the nation’s aim to employ empathy in medical practice. Dartmouth should follow suit, starting at the undergraduate level.
Similar to the brainchildren behind TDI, the revamped organization of Dick’s House and Dartmouth’s premedical curriculum should serve as models for the nation to reinvigorate empathy in health care delivery. We could use a taste of our own medicine.