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Patients Are Often the Best Instructors in Medical School

Yash B. Shah

Disclosures

February 02, 2022

As a medical student, you are constantly learning, certainly from faculty and other healthcare professionals in the clinical setting, but also from the patients whom you are serving. Often, the patient knows far more than the medical student who may have never even heard of the medical topics in question. Many times, I have personally interacted with a patient who has done extensive research after their diagnosis and proceeds to teach me quite a bit about a condition with which I am entirely unfamiliar.

Patients can also educate students — and even seasoned physicians — about the experience of navigating a complicated healthcare system or the unending and oft-unrecognized challenges of living with a chronic condition. These are experiences that cannot be easily communicated via lecture or textbook and are frequently not well-understood by providers.

Although our coursework is valuable in teaching the science of underlying disease and therapeutics, many other factors can influence health. Real-life challenges arising from socioeconomics, such as access, affordability, transportation, and the psychological effects of a difficult diagnosis, have outsize impacts beyond the biological bases that are taught in class. An adage that has gained recent popularity is that an individual's zip code has larger affect on their health than their genetic code.

Through the Health Mentors Program, I teamed up with students from other healthcare training programs (such as nursing, physical therapy, social work, and nutrition) to learn from a local patient who lives with a chronic condition.

Because our group resembled a comprehensive healthcare team, we used our unique perspectives and specialized professional roles to gain a holistic understanding of our patient. It was enlightening to discern the hidden, nonmedical challenges that patients face after a life-changing diagnosis.

Our patient deals with a host of chronic conditions that necessitate numerous daily medications and pose extensive limits on her mobility. Hearing about the challenges that she faces in following complicated prescription regimens and attending frequent medical appointments, I learned that it is important for providers to consider these smaller, less obvious factors when partnering with patients to safeguard ease of adherence.

Affordability was the first challenge that came to mind for me, but there is a host of other issues that accompany chronic disease self-management.

Our patient discussed her gratitude for in-home nursing care for assistance with daily activities and emphasized her desire for an empathetic care team that not only assigns the optimal treatments but also shows humanity and teaches her how to advocate for her own health. These conversations helped our team understand how to best optimize a patient's experience and how to leverage each team member's role toward this end.

I believe that physicians of the future should work harder to collaborate with skilled nursing staff — whether via nursing homes or in-home care — to offer better preventive and patient-oriented services for our communities. This will reduce numerous issues that we face today, including high costs and the nursing home–to-hospital revolving door.

Moreover, our team learned how the COVID-19 pandemic has particularly affected patients like ours, compounding the loneliness and anxiety that many of us have faced during these past few years. Providers of the future will certainly have to account for the pandemic's resulting and everlasting stress, trauma, anxiety, and physical detriments on patients.

Perhaps, the most important lesson I learned is that prescribing a medication or performing a procedure is not the end goal. There are substantial germane nonmedical challenges that physicians must appreciate to ensure their patients' well-being. Whether that includes our evolving understanding of mental health or our new realization of the profound effects of social determinants, it has become clear that biology alone cannot explain disease and treatment.

Many of these challenges are outside the control of the physician, who must partner with other specialists — and the patient themselves — to ensure longitudinal and comprehensive patient care. Medicine is truly a team sport, and physicians could not accomplish much without their coworkers.

Though a strong scientific knowledge serves as an excellent foundation to patient care, many other factors, including compassion, regard for social determinants, and partnership with other healthcare professionals, is vital to ensuring optimal patient experiences and is truly best learned by talking to patients.

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About Yash B. Shah
Yash Shah is a first-year medical student at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, Pennsylvania. He earned a bachelor of science in premedicine from Penn State University. Prior to attending medical school, Yash worked on clinical and translational research in hematology/oncology at the Children's Hospital of Philadelphia. Yash has long-standing interests in advancing medical education, improving healthcare policy and economics, and working with cancer patients. In his free time, he enjoys playing tennis, rooting for the Eagles, reading, and traveling.

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