Patient Responsibility: "Consider Participating in Medical Education"

Continuing on with the topic of patient responsibility which was mentioned in the Comment section of the last post on the “Tired Doctor”, there is an article titled “A Responsible Patient” in the April 2003 issue of "Virtual Mentor. In the article, the American Medical Association's Code of Medical Ethics, Opinion 10.02 , regarding patient responsibilities is quoted as

“to include, but not limited to the responsibility to:
1. Be truthful and express their concerns clearly to their physicians.
2. Provide as complete medical history as possible .
3. Request information or clarification when they do not fully understand their health status or treatment.
4. Cooperate with agreed-upon treatment plans and appointments.
5. Take personal responsibility when they are able to prevent the development of disease.
6. Consider participating in medical education by accepting care from medical students, residents, and others”

I was particularly intrigued by item 6 “Consider participating in medical education by accepting care from medical students, residents, and others”. I wondered whether patient’s entering a clinic or hospital for medical or surgical treatment really enter expecting they should consider being possibly altruistic by accepting care from “medical students, residents and others” as part of contributing to medical education.

Medical training hospitals routinely may have a statement about medical education, usually in small print, somewhere on their admission papers for the patient to sign but do patients really understand what is going on? Is there specific or verbal communication by the hospital or the patient’s personal physician about what is going on? How do patients feel about being interviewed, examined or cared for as part of medical education if they learn about this before the experience or only afterward?

As teachers of first and second year medical students, we routinely and directly ask patients if they would approve having a medical student interview and examine them, explaining what the student would be doing. If the patient, for whatever reason, rejects the offer, the patient is not criticized but we go on and try to find another patient. Since I don’t participate in medical education in the later years, I am not fully aware of the timeliness or degree of informed consent that is given to patients. But I suspect that it is not the same as what we do in the first two years.

I,personally, would be greatly interested in comments by physicians and patients about this subject. One particular point that I would be interested in knowing is whether physicians, themselves, would accept examination and care by those still formally learning. ..Maurice.