What do you want to unlearn?

With change fast and furious as always, how relevant is what your school taught you two or more decades ago? What is it that you have had to or want to unlearn to cope with today?
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Medscape asked this question recently about medical school. Even before I read the article in full, I shared the same question with a few doctor friends. I expected some finger-wagging about the need to keep up with technology and some frowns at the interfering Dr Google. I also expected doctors in the US and India to come up with different answers. Well, surprise!

What Medscape gathered

This is the gist of what Medscape gathered.

• Treat pain and don’t be shy to use “controlled medications”.
• Spend more time in college for pain education.
• Don’t just treat, focus on lifestyle and preventive medicine.
• Patient care has become dehumanizing. Relearn how to listen to patients, gather history, and conduct an examination using hands and a stethoscope.
• Physicians must learn to heal themselves.
• Practice with sensitivity to gender. In medical school, a male figure is used to teach most of the anatomy except when the subject is the female reproductive system.
• Racial disparities are real. Focus on concepts like epigenetics to serve a safer, healthier and more equitable world.
• Yes, there is a lot of information available now on fingertips. Study and apply well to patient care in a timely manner.   

What my doctor friends said

• Drop the paternalistic attitude. You are doing your job, what you are trained for.
• You are a fellow human being. Introduce yourself first to the patient.
• Avoid talking down to the patient who will most often be in the supine position. Pull up a chair or stool so that you are at eye level with the patient.
• Be compassionately honest. Think before you say, “I know”. A more honest answer would be “I can imagine”. You can never really know the patient’s pain, physical or emotional. But you can be empathetic enough to understand and help.
• Pain is what the patient says it is. And patients are people with feelings.
• You are not defying science if you decide to pray before you pick up the scalpel.
• Do not get lost in statistics. Use the numbers the studies throw up as a guide. The prescription has to emerge from your interaction with every individual patient, not from any template.
• Today’s medicines are wonderful and can do about 30% of the job very well. More important is how you approach the problem and how you communicate (listen, mainly).
• If your college was focused on serving a large number of poor patients, switching to the cut-throat commercial world can be confusing and painful.
• Do not let urgent need to recover the millions you spent on medical education dictate your fees. Your competence and experience (both of which need time to establish) ought to decide that.
• Colleges barely teach you to deal with the phase of life leading to death. Know that care matters until the end, with or without medicines.

What have you unlearnt?

Yes, apparently robots are wonderful surgeons today. But the patients are not automations. The core message from everywhere appears to be to take time to listen and clasp a hand before the robot takes over. 

I am grateful to my doctor friends who were kind enough to share their opinion. Special thanks to Dr Srinagesh Simha, Dr Khurshid Bhalla and Dr Pushkar Khair.
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So much about the medical profession. What about your profession? Is there something you have unlearnt? Is there something that was taught to you decades ago, but you disagree with today?