Thirty years ago this summer, I stepped out of the lecture hall and library and onto the hospital ward. I was starting my first medical school clinical rotation.
I remember sage advice I received from a faculty member the first day of that rotation. He said, “Don’t let the scut work keep you away from the patient.”
Those were the days prior to computers in medicine, and the phrase “scut work” was used to describe the mind-numbing but absolutely necessary busy work (most of which fell on medical students) of chasing down information, scheduling tests, etc.
Indeed, it was sage advice. I spent endless hours and walked many miles throughout the hospital trying to find medical charts, looking for the results of blood tests, or the most dreaded task of all, searching for the pack of X-rays that had images I needed to see but had been checked out of radiology.
Indeed, I still recall the feeling of dread when I learned that an X-ray I needed was locked in the office of the Chief of Surgery. My classmates and I consciously focused, with mixed results, on spending enough time with our patients despite the scut work that needed to be done.
Fast forward 30 years. My daughter is now starting her first clinical rotation in medical school. The challenges she and her classmates face are very different.
Thankfully, the scut work we did as a medical students is a thing of the past. A password and a few clicks of the mouse provide her with the latest lab results and X-ray images on her patients.
The current generation of students, however, faces a different risk that can also threaten their time with the patient . That is the risk of becoming an “eDoc.”
As I was walking through the hospital recently, I saw a long row of medical students and residents hard at work. They were not spending time with patients, which is vital to becoming a good physician, but were staring at computer screens. Just as some scut work was necessary in my day, some computer work is necessary today. However, it is vital that these future doctors don’t let ready access to information replace spending time with patients.
Accurate information has always been a part of good medicine, but does not replace the importance of face-to-face time with the patient, which is irreplacable for both a medical student who is learning and for more experienced physicians who are responsible for the patient.
The patterns that medical students develop during their clinical rotations will be with them throughout their careers. I therefore will paraphrase my former faculty member when I give advice to my daughter’s medical school class and say, “Don’t let being an ‘eDoc’ keep you away from the patient.”
George Weiner, MD
Holden Comprehensive Cancer Center Director