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How Personable Is Your Doctor (of the Future)?

July 11, 2011
by Mark Hagland
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Could a shift in medical school admissions processes lead to better listeners—and better clinical IS?

This week, the New York Times published a fascinating article on a strategic change that medical school admissions officers in the U.S. and Canada are making with regarding to selecting which applicants for available slots in their medical schools. According to the Times, at least eight U.S. medical schools and 13 Canadian ones are putting candidates through what the article describes as “the admissions equivalent of speed-dating: nine brief interviews that force candidates to show that they [have] the social skills to navigate a healthcare system in which good communication has become critical.”

The article goes on to describe the process as it is unfolding at Virginia Tech Carilion, the newest U.S. medical school. There,”26 candidates showed up on a Saturday in March and stood with their backs to the doors of 26 small rooms. When a bell sounded, the applicants spun around and read a sheet of paper taped to the door that described an ethical conundrum. Two minutes later, the bell sounded again and the applications charged into the small rooms and found an interviewing waiting.” The candidates had to quickly explain to their interviewers how they would handle specific ethnical situations as physicians.
The results were used to help select this fall’s incoming class of first-year students. “We are trying to weed out the students who look great on paper but haven’t developed the people or communication skills we think are important,” Stephen Workman, M.D., the school’s associate dean for admissions and administration, told the newspaper.

In short, as the article noted, leaders of the nation’s 134 medical schools are beginning to shift away from what historically has been a near-complete reliance on college grades and results from the Medical College Administration Test (MCAT) to choose the nation’s future doctors.

This shift is supported by increasing numbers of studies that have uncovered the extent to which communication problems contribute to the nearly 100,000 preventable deaths in hospitals each year. For example, the Joint Commission has found in studies over the past several years that communication problems are among the leading causes of medical errors.

So here’s an interesting question: if we end up in the next decade getting more young doctors who are better communicators and have better people skills, how might that impact clinical IT implementations, and even the use of EHRs and other clinical information systems? While no one can predict anything like a one-to-one correspondence (such as, “more sensitive physicians = automatic improvements in care quality), who can say that physicians as a community might not better leverage the EHRs and other clinical information systems that already exist? After all, information systems are just that—systems—and it is ultimately always human beings who make the clinical decisions.

I’m also intrigued by the idea that having a higher percentage of physicians who are good communicators will lead to better exchanges and collaborations with IT leaders, whether CIOs, CMIOs, other medical informaticists, other healthcare IT managers, and so on. After all, all those folks are trying to help physicians in practice, whether in inpatient or outpatient settings, to find ways to optimize their use of clinical IS, in order to improve patient safety, care quality, efficiency, cost-effectiveness, etc. And might not those better exchanges and collaborations ultimately lead to better clinical information systems, and then ultimately, better care delivery?

Who knows where this shift in medical school admissions processes will lead? I for one am optimistic that good things will come out of it—results that patients, families and communities will benefit from.