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Healthy Skepticism Library item: 18978

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Sierles FS
Perspective: The Revolution Is Upon Us
Academic Medicine 2010 May; 85:(5):799-805
http://journals.lww.com/academicmedicine/Fulltext/2010/05000/Perspective__The_Revolution_Is_Upon_Us.21.aspx


Abstract:

Profound socioeconomic pressures on medical student education have been catalogued extensively. These pressures include teaching patient shortages, teacher shortages, conflicting systems, and financial problems. Many of these problems have been caused by an unregulated free market affecting medicine overall, with market values sometimes overshadowing the academic values of education, research, and patient care. This has caused profound changes in the conduct of medical student education. Particularly important has been a reduction in the “gold standard” of teaching: direct student–teacher and supervised student–patient interaction, replaced by a potpourri of online and simulated modules. The aggregate of these changes constitutes a revolution that challenges whether medical schools, school buildings, classes, and dedicated faculty are even necessary. The author posits several recommendations in response to this revolution: (1) recognize the revolution as such, and carefully guide or abort it, lest its outcome be inadequate, inauthentic, or corrupt, (2) prioritize academic rather than business values, (3) ensure that funds allotted for education are used for education, (4) insist that medical schools, not industry, teach students, (5) value authentic education more than simulation, (6) adopt learner-centered teaching without misusing it, (7) maintain acceptable class attendance without requiring it, (8) provide, from the first school day, authentic, patient-centered medical education characterized by vertical integration, humanism, early patient exposure, biopsychosocial orientation, and physician role modeling, (9) ensure that third- and fourth-year students have rich patient-care responsibility, and 10) keep tenure. These actions would permit the preservation of an educational gold standard that justifies medical education’s cost.

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963