Today’s post is very personal, but it has a larger point too.
My father was a gastroenterologist and medical school professor in New York City. Every day he would take care of his patients, come home and have dinner with the family, and then, after the rest of us had gone to bed, he would pore over medical journals late into the night.
As a young girl I used to worry about him. I thought that surely he couldn’t be happy this way, night after night, alone with his work. It was only when I grew up and turned into someone who devours psychology journals that I understood how happy my father actually was. And, of course, all that studying made him one hell of a doctor.
I thought about this when I came across an article alleging that most doctors are too busy and overworked to read medical journals.They rely on what they learned in medical school, and fail to stay current with developments in their field. Here’s William Shankle, M.D. and professor at U.C. Irvine:
“Most doctors are practicing 10 to 20 years behind the available medical literature and continue to practice what they learned in medical school….There is a breakdown in the transfer of information from the research to the overwhelming majority of practicing physicians. Doctors do not seek to implement new treatments that are supported in the literature or change treatments that are not.”
Doctors do have “continuing medical education” requirements, which they often meet by attending conferences at beach or ski resorts.
My mother, who accompanied my father to these conferences, used to tease him about being the only participant to sit through every session, in the front row no less. He taped them all, and then in his hour-long commute to work, he would listen to the tapes, over and over again, until he’d absorbed the information. Even now, when he no longer practices, he still attends gastroenterology conferences, because he’s excited to find out “what will happen next” in his field.
This post is partly a paean to my father, but it has broader implications. Lately, medical schools have started screening applicants for people skills. This comes from an admirable impulse – we’ve all felt the sting of doctors who don’t listen, or address us or their teams brusquely – but I wonder how effective these tests are. My father wouldn’t have shone in that kind of assessment – he doesn’t enjoy talking for its own sake - but his patients loved him because they knew how much he cared. Maybe instead of testing for social skills — which can favor a glib charm, even if that’s not the medical schools’ intention — we should be screening for kindness, curiosity, and a thirst for quiet study.
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I think people skills are huge. You can be the best doctor, programmer, engineer, brick-layer, or teacher, but if your people skills aren’t there, your value to the institution and people you serve is diminished.
But, the model for people skills has to include individuals like your father. People skills are much more than general friendliness, and needs to include softer skills like motivation, empathy, and curiosity.
So let’s screen for people skills, but let’s also make sure introverts are designing the tests.
I think that many introverts are good at the people skills that I look for in a doctor, such as listening and asking thoughful questions. I think you said it all - “his patients loved him because they knew how much he cared.” The ability to show caring is only marginally related to gregariousness or an outgoing personality.
I think it can take introverts longer to develop their people skills, especially in a society like ours that values the ability to talk a lot. But by the time we’re out of college, I think that lots of introverts are good at communicating caring and conscientiousness, especially in the one-on-one situations common in medicine.
In the end I would prefer a Dr House when I am in dire need. Most doctors I have endured in life are in the belly of the beast (one standard dev) and seem to be body mechanics. Give me someone who is out there at least 2 Std Dev. I am sure your fathers patients appreciated his dedication to understanding. I wonder what the ratio of introverts to extroverts is out there in the tail of the bell curve of doctors?
Medical schools teach practical skills, but we also need doctors who understand science-based medicine and who keep up with the literature. Too many doctors don’t have the skills to respond to alternative medicine, fears about vaccination and other superstitions that are all too common. I believe most doctors are naturally curious and doctors want what is best for their patients. Susan, if doctors do stay current like your father always did I think they can help educate patients and make them feel more comfortable and confident in their treatment.
yes! right on. And it starts even in admission to pre-school and later to college, where I noticed the admissions personnel seek out the liveliest, me-firsters, and do not know how to distinguish those more thoughtful ones. Throughout elementary and high school educations of my two children I saw teachers deal ineffectively with kids who called out (frequently wrong answers), declaimed their superiority by crowing they knew the answer(false ego boosting, AND a zero sum game as it does hinder the progress of other children), and give the most time to the loud ones. Teachers need to learn how to share the attention around, and how to draw out and give equal credence to the quiet ones. Our society rewards those who thoughtlessly claim attention loudly. Even in college admissions the personnel chose the predictably theatrical personalities over the thinkers. Curiosity, kindness. personability, human connectivity are deemed female and inconsequential qualities, yet they are the ones determining longevity in a career.
One of the reasons I DIDN’T pursue a medical degree was that I lacked the “extroverted” personality traits desireable in the application process (and now what clubs did YOU belong to? What volunteer program did YOU lead? et al). I have always wondered had the process been more thorough and thoughtful as to who would make good doctors. I know that I sometimes get very frustrated with my own MD who seems to talk the entire time I am in his presence.
I think what makes a good doctor is first and foremost an empathetic nature, intellignece and then a life long desire to improve oneself. That is perhaps the makings for excellence in public service professions. I don’t think introversion comes into play here. I have met teachers who lack empathy and the desire to improve and by the time they have been teaching ten years they are on auto-pilot with a seen-it-all mentality. I think doctors, nurses, public defenders etc. can get that way if they are not careful or don’t start off with empathy in their back pockets. I am blessed with a brilliant GP who is empathetic, humble, extremely intelligent and a life-long learner. I only wish we were the same age! I dread hearing her say she is retiring!
I’m glad I came across this article, Susan. I just finished reading your book Quiet about ten minutes ago and throughout all the reading I was wondering how introverted physicians are seen by society or if they are at all acceptable. I am a premedical student applying to medical school right now and I’m just afraid to be rejected by the schools only because I may come out as a shy and introvert applicant, specially during the soon-to-come interviews (some of which are made in set of groups). I know I love medicine and I’ve put myself through lots of experiences that admission committees are looking for, like volunteering, shadowing, research, summer programs, etc that have reinforced my decision of pursuing this career but I still think that if I’m tested for social skills I will shine very little. I’m glad I found your opinion about this matter. Thanks!
As an introverted physician who has been in practice in ICU medicine for nearly 20 years now, my career has definitely had its ups and downs. Your father sounds like the pinnacle of what I would consider the ideal physician, one who cares enough to show compassion and knowledge to patients as well as to dedicate significant “free time” to keeping up with the medical literature and his craft.
I do not really find that I have any difficulty with patient and family interactions. I do care about my patients and their families and as such do not really find listening, sharing information and stories, and participating in this moment in their lives to be a challenge at all. I enjoy clinical research, teaching, and writing a great deal. I love reading and would choose an evening with journals over an evening with most people in a heartbeat. I wish my group members valued ongoing education more, and I hope that medical schools don’t lose the forest for the trees in looking for folks with great personalities who aren’t as dedicated to the intellectual pursuit. Caring and listening are one thing, bubbly but lacking sufficient knowledge another.
I struggle mightily with the social aspect of the medical care team. I don’t do politics well, and medicine is rife with it. I tend to be a quiet listener and then an astute but blunt problem solver, which is interpreted as aloof and bitchy if I’m not careful. I find the practice gossip nauseating, and I’m not good at talking about facebook and soccer games with the group wives (I’m one of the few females in the group). And, I just don’t “chat.” So, I’m considering dropping back from full time clinical practice to pursue more medical writing, just as an opportunity to recharge my batteries a bit and to escape from so many of the social and administrative interactions.
I think introverts can be outstanding physicians. But, it can be exhausting for anyone, perhaps even more so for an introvert.