People skills, pre-meds, medical students and doctors

Parent Cafe
1

I wanted to open a separate thread on this topic, although it has been touched upon in a thread about organic chemistry for a pre-med student. It is off-topic from the main discussion in that thread.

A while ago, I read a column written by a physician who was blaming permissive child-rearing practices for some difficulties he was encountering in pediatric practice. As I recall, he gave an example where a patient of his needed to have a throat swab for a suspected case of strep throat. The accompanying parent asked the child something like, “Would you please open your mouth for the doctor?”

Predictably enough, the child said, “No!” (after all, the child was feverish and had a very sore throat).

So far, okay. However, the pediatrician wrote that he eventually had to restrain the child to get the throat swab.

The pediatrician said that the parent should have given the child a directive, rather than a question. He expected immediate obedience.

This started me thinking: Would I want a grand-child to immediately obey a stranger (to them), just because the person was in a position of authority? My answer to that is, “No!” Or maybe “[Deleted] no!”

This is a situation that I think might have been handled better; and in my opinion, it is a valid example of the utility of people skills for a physician. The time limits for office visits under managed care no doubt complicate this, though.

On the other hand, I really do not like the stereotype of a very intelligent and hard-working pre-med student as lacking in “people skills” and being “mushroomy” (loner, stays in the room and studies). Aside from the fact that that’s not a successful strategy for med school admissions, it seems to me to be a common negative stereotype of very bright students on CC. Please bear in mind, a lot of them were “born that way.”

2

Not sure I understand your premise.

Doctors come in all flavors, just like any other professional. There are lawyers with tremendous people skills and empathy and emotional intelligence and others without; ditto for architects, petroleum engineers, etc.

Architects with strong listening skills are going to have different types of professional experiences and successes than those without. An engineer with charisma and leadership skills will likely have a different career path than an engineer who is an introvert.

What exactly are you asking and why are doctors presumed to be different than any other professional?

3

The original post reminds me of the time when D1, age approximately 7 at the time, got a big gash on her leg. We took her to urgent care, and the treating pediatrician was dismissive about D1’s fear and anxiety as she was being treated. It was a one-off (really; this physician was the one my daughters switched to when they teenagers and decided they felt more comfortable seeing a woman and she worked out okay for them then) but I still recall how unfriendly the pediatrician seemed when faced with a very upset 7 year old.

4

I chose our pediatrician solely because of people skills. I have a very obstinate child. In some ways, this is a good thing, but it would not have mattered one iota whether she was asked to open her mouth or directed to do so. Immediate obedience in a sick child lacking the knowledge to understand and rationalize why she should open her mouth should not be expected.

I do think there are some specialties in which people skills are required more than others, pediatrics being one of them. I didn’t fully appreciate the importance of people skills involving young children until mine was a patient at our local children’s hospital.

They may not be as important in specialties such as cardiology.

5

There are different types of patients…as well as different types of doctors…in terms of personality.

6

One of the toughest times I can remember was when my toddler was hospitalized when she was 1.5 years old and they would insist she be taken away and all alone when treated. Both D and I found it very tough that they wouldn’t let me hold and comfort her. Fortunately, we were only at the hospital for a few days but it seemed like forever.

7

Why I raised this: On the organic chemistry thread, there were scattered posts from CC members who preferred physicians with strong people skills vs. those who preferred physicians with strong academic qualifications. The discussion there was just focused on pre-meds, med students, and physicians–plus organic chemistry, and whether it was a tragic waste that pre-meds had to take it, or whether it was worthwhile for a physician.

It goes without saying that a person could have both people skills and strong academic qualifications, or neither. Also, I don’t want to artificially conflate strong academic qualifications with GPA, since there are a lot of ways to attain a high GPA, some of which do not involve strong academic qualifications.

I have posted a rather lengthy example (original post) where I think that people skills are highly important.

But in general, I am wary of the proponents of “people skills” over knowledge and capability, if one had to choose one or the other.

I agree with tutumom generally speaking. I have encountered a few students who would be fine pediatricians as long as their patients had nothing seriously wrong with them (or as long as they were capable of recognizing when they were in over their heads, and would direct the patient to another physician).

8

It’s hard to think of a profession or job where good people skills wouldn’t be advantageous, all other things being equal.

Some medical specialties require fewer people skills than others. A pediatrician really needs to enjoy all kids, especially crying kids, along with worried parents, and somewhat chaotic work conditions.

But a pathologist really doesn’t need great people skills (compared to a pediatrician).

People seem to be attracted to (and sort themselves into) the specialties that serve their areas of interest and strengths.

9

“But in general, I am wary of the proponents of “people skills” over knowledge and capability, if one had to choose one or the other.”

By the time a student has gone through undergraduate, medical school, and residency, I believe it is safe to assume that they all have knowledge and capability (or at least they should). Therefore, yes, I do think people skills become more important - that “hook” if you will, if you plan to see patients vs. being a research/teaching physician.

10

With primary care in a population center, patient panels tend to reflect on the personalities of the provider. The female doc who runs behind but talks forever ends up with mostly stressed housewives. The sciencey internist has a bunch of programmers as patients. Her ex-boss, with the loose prescription pad, had all the back pain opiate addicts. Front desk people often can tell the provider of the person walking in.

It’s good that she knows the specialists. She can match her patients to the right specialist, and warn them what to expect.

It is astounding to her how many people are going through treatments that have not been explained to them to the point they understand. She sets up appointments for specialists who are good at explaining things, especially oncology. Their specialty could use a course on bedside manner and plain-English medicine.

11

Given the selectivity of medical school, theoretically there should be plenty of people with both to fill medical schools.

However, the pre-med weeding and selection process may select much more strongly for one and not select for the other strongly enough, producing a suboptimal medical school applicant pool from the standpoint of needing both.

12

As a mother, when I took my kids to the doctor, I prepared them for what was about to happen. There are expectations in a doctors office–this is not some random person on the street asking him to open his mouth. The mother should have intervened immediately and told her little snowflake to “open up”. Personally, I always want a smart Doctor. I do not care about his/her people skills.

13

Few, if any, doctors are not smart.

14

I agree that the great majority of doctors are smart, more or less. However, it is a commonplace among STEM faculty to be very concerned about ever becoming the patient of some of the successful pre-med students we teach. (Just reality). It’s not because they lack people skills. :slight_smile:

15

I’ve had to write med school recommendations for a few students (haven’t you, QuantMech?) One of the questions on the med school rec letter form is about what kind of “people skills” or bedside manner, if you will, the applicant has. Obviously, med schools feel that this is something important to consider. Having had a doctor or two who treated me like an idiot, I’d consider it an important feature myself.

16

People skills? Nobody would disagree that a doctor with “people skills” is a good thing. However, it is a specious concept. If there were a true market for medical care, a patient could choose the doctor and the doctor could choose the patient and the most peculiar or each group could be satisfied with the mutual interaction. However, as it stands, each is stuck with the other.

In my experience, some of the most beloved doctors are some of the absolute worst (and among the best). Patient satisfaction in the absence of patient/doctor choice is not tantamount to quality as medical administrators like to think. Some doctors are paid, in part, based on patient satisfaction. If you are a doctor dealing with difficult situations (e.g. psychiatry, pain management) one could just as easily make the opposite argument!

It would be great if the average patient could spend a day behind the scenes in an emergency room, a mental health unit, a family practice office. The experience would be sobering and the notion of “people skills” would be redefined. I am about to retire and the nurses jokingly bought me stationery that says: “From the desk of Dr. ?!%$ &%#** _)##@# %$K@#@#$” imitating what they have heard patients call me when not getting what they wanted.

The acceptance rate to the easiest medical schools is lower than the acceptance rate to the most selective colleges - and that is absent the massive marketing budgets that induce unlikely applicants to apply. Also, the pool of applicants is generally absent the legions of pre-med students who have been weeded out along the way. Expecting that cohort to be a bunch of Trapper John’s is a bit unrealistic - it is more likely to be a museum of personality oddities no matter if the pre-med student is forced to take an extra humanities class in college.

It might be more practical to encourage “patient skills” so that the typical patient who is stuck with few physician choices is able to get sufficient satisfaction from the interaction.

17

Hear, hear on patient skills WISdad.

Patients who demand an antibiotic for what is almost certainly a viral infection.
Patients who demand an MRI for what is almost certainly a sprain which will recover by rest and (maybe) ibruprofen.
Patients who are non-compliant on their meds but are relentless in calling their doc to find out why they aren’t getting better.
Patients who are heading for a knee replacement (15 years ahead of what would be expected) because the “diet and exercise routine” their MD has recommended “doesn’t work with my lifestyle”.
And the family of patients (let’s call the patient a 90 year old woman with advanced dementia) demanding chemo for a relatively slow advancing cancer which a team of docs has determined will NOT be the cause of death (the alzheimer’s is moving faster than the tumor).

18

If my child is in a doc’s office and child won’t open his mouth, I would say, “OPEN your mouth!”.

this has nothing to do with blind obedience to strangers, this is a case of a parent acting like she needs the child to agree with opening his mouth for doctor. Uh, no.

19

^ because yelling at a feverish child with a very sore throat is always a good idea . . .
Everybody has his/her own style of parenting. Mine did not involve giving commands.
There are other ways to handle the situation.
But I understand that other people’s styles may work better for their families.

20

There is no “people skills” that can change a child’s response to a stranger ( in this case a doctor) in seconds or minutes. This is the responsibility of the parents to let the child know what he/she expects in a doctor’s office. They should be taught well in advance, not just before the doctor appointment when they are unwell.