July 28, 2011

Lecturer delves into rapidly changing culture of medicine

Lecturer delves into rapidly changing culture of medicine

D. Craig Brater, M.D., is a distinguished clinical pharmacologist and dean of Indiana University School of Medicine. But in his address Monday to clinical scientists at Vanderbilt University Medical Center, he didn’t discuss research.

D. Craig Brater, M.D.

D. Craig Brater, M.D.

Instead, he talked about changing the “culture” of medicine.

Change is hard. But patients are demanding more collaboration, efficiency and “service-oriented” care from their doctors. “Is there any doubt that we need to change the culture of medicine?” Brater asked. “Isn’t academia the place to start and to lead?”

Brater spoke at the 12th annual Visiting Scholars Day dinner at the University Club hosted by the Vanderbilt Office of Clinical and Translational Scientist Development. Earlier Monday, he met with several faculty members and “scholars” in Vanderbilt’s research career development programs.

These include the Elliott Newman Society, a professional organization for M.D. and Ph.D. scientists supported by the Vanderbilt Physician Scientist Development program, the Vanderbilt Clinical and Translational Research Scholars program, and by career development awards from the National Institutes of Health.

Indiana began its culture change more than a decade ago, with an articulation of core values including excellence, respect, integrity, diversity, cooperation and professionalism. They were developed through “appreciative inquiry,” asking faculty members and other stakeholders to identify the best of what they do.

“Organizations change in the directions in which they inquire,” Brater explained. “If you’re going to dwell on the negative, everybody’s going to be crabby. If you’re going to dwell on the positive, that lifts everybody up.
“It sounds a bit corny, but I’ve been amazed at the impact this has had.”

Today, prospective faculty members and students are evaluated in part according to the school’s guiding principles. “I don’t care how thick your CV is,” Brater said, “if you don’t embrace our values and our culture, then we don’t want you to come here.”

Brater choked up when telling the story of Chris, a medical student who experienced the death of a patient on his first clinical rotation. The attending physician, who was out of town at the time, thought the family would be upset by his absence.

Instead, the patient’s daughter told him she knew why her father had suffered – it was “to make Chris a better doctor.”

“Is that the kind of culture we have, where every patient we see … is trying to make us a better doctor?” Brater asked. “If we don’t, shouldn’t we?”