Learning medicine is a complex task.  One must know enough basic science to understand disease processes, diagnostic testing and treatment strategies.  Excellent physicians develop a strong knowledge of the evidence for tests and treatments.  We must learn constantly about new drugs – their actions, their benefits and their side effects.  Yet complete knowledge of all these issues do not make one an excellent physician.  Medicine requires more than scientific knowledge.

Great physicians have bedside skills.  They read body language, and recognize sickness.  They can perform and process the physical examination.  Perhaps most important is the doctor patient verbal interaction.

Great physicians take the medical history like great detectives interview witnesses.  History taking requires great knowledge of differential diagnosis.  It requires a nimble mind, one that reacts to patient cues like a jazz musician reacts to other band members.

Great physicians understand how to motivate patients, they focus on helping patients develop healthier lifestyles.  They can deliver bad news and yet emotionally support the patient and family.  They help patients through words and touch.

How does one learn to be a great bedside physician?  Hopefully, one benefits from various role models.  Those who teach should regularly reflect on the skills that they want to teach.  Those who are training should learn from each attending and colleague.

Now for the challenge.  I am very interested in your thoughts on the necessary components of a bedside curriculum.  For those already practicing – what skills are most important, and how did you learn them?  For those still in training, what do you value related to bedside skills?  For the non-physicians, what should we do a better job of in our training?

Thanks in advance for all your thoughts.

“Medicine is learned by the bedside and not in the classroom. Let not your conceptions of disease come from words heard in the lecture room or read from the book. See, and then reason and compare and control. But see first.” – Sir William Osler