In another development that at first glance might not seem very momentous may help hasten the end of the medical profession as it is currently constituted. The Medical College Admissions Test, or the MCAT as we knew it fondly, is undergoing a transition that will be complete in 2015. In addition to genetics and cellular and molecular biology there will be a new behavioral and social sciences section. An article in the US News and World Report states that “The intent of this addition is to assess a student's ability to understand, empathize with, and communicate well with patients of all cultural and socioeconomic backgrounds—an aspect of practicing medicine that's become more important as the nation becomes increasingly diverse...” Bonnie Miller, senior associate dean for health sciences education at the Vanderbilt School of Medicine, feels the MCAT's expanded measures of science and social awareness will better reflect the skills needed by doctors in a rapidly evolving medical climate.
"The proposed changes in the MCAT are much needed," she says. "Physicians of the future must be critical thinkers who can manage complexity in diverse settings, from ethical dilemmas within families to the operations of integrated health systems…The proposed changes will better align the MCAT with the measurable traits we seek."
Now as I attempt to decipher what this actually means, I wonder if those in medical education deem the physician of yore, or even the one of today as inadequately equipped to deal with the needs of tomorrow’s or even today’s patients.
As Dr. Doug Perednia notes in his “Road to Hellth” blog, this appears to be an attempt to craft a new breed of physician. The new course taken by the medical education establishment apparently desires to construct a new kind of touchy-feely physician that is ready and willing to be able to handle the ethical dilemmas that might arise from this brave new world of healthcare, one who is able to deftly navigate the intricacies of the “operations of integrated health systems”.
What ethical dilemmas, one might ask? Oh, something akin to what the esteemed DrRich has written about, that is the new ethics of medicine. The dilemma of how to appear to be an advocate for the patient yet have as true motivation what is most cost-effective for society. It will take a great deal of psychological and sociological gymnastics for today’s current docs to get on board with this sort of program, so it inevitably must be sought for in the medical school admissions process.
“Operations of integrated health systems” is likely another word for a guideline-driven, Accountable Care Organization-heavy system that will be notable for its reliance on a cookbook approach towards medical care, and the requisite empathy and cultural awareness needed by the purveyors of medical care to sell this mess to every patient in the nation. In reality, what I want when I am ill, and what anybody else truly wants in that same position, is a physician who is well-trained in the science of medicine and to use that training to inform me of my condition and how to best ameliorate it. Our nation is apparently not prepared to continue to train this sort of doctor.
With this to look forward to, no wonder so many docs are getting out. Would the last one out turn the light off when she leaves?