Penn Pairs Chronically Ill Patients With Medical Students To Create Better Docto

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Penn Pairs Chronically Ill Patients With Medical Students To Create

Better Doctors

http://www.medicalnewstoday.com/medicalnews.php?newsid=38843

Can someone who suffers from a lethal genetic disease teach a pair of

medical students to become better doctors? That's the goal of a

unique, long-term patient-student pairing program at the University

of Pennsylvania School of Medicine.

Doctors-in-training -- like Guerry, a second-year medical

student at Penn -- are learning what it's like to live with cystic

fibrosis (CF), and many other chronic health conditions. They're

shadowing patients with chronic conditions such as HIV, asthma and

kidney failure. The students are taking part in the " Longitudinal

Experience to Appreciate Patient Perspectives (LEAPP) " -- a program

at Penn's medical school - in which students are paired with

chronically ill patients for several years.

" The goal of the program is to better understand what the patient

must go through and to improve doctoring skills by learning from

those experiences, " explains Lanken, MD, Professor of Medicine

in the Pulmonary, Allergy and Critical Care Division at Penn and

Director of the LEAPP program. " We want to produce better doctors...

doctors who have a real compassion for what the patient is going

through, including their daily struggles with a serious chronic

condition. "

Medical Student Paired With Patient Deb Becker...

Deb Becker has battled Cystic Fibrosis (CF) - a disease characterized

by thick mucus in the lungs that affects breathing and digestion --

more than half of her life. The 50-year-old grandmother first noticed

the symptoms of CF at 16 and was diagnosed with it at age 25. Becker

eventually lost her oldest sister, who also suffered from the

disease. And throughout Becker's life, as a single parent, she has

been in and out of the hospital often. But she persevered, " You put

one foot in front of the other and do what you need to do. "

On oxygen round the clock, Becker, a Shiloh, New Jersey resident, has

limited mobility. Cystic fibrosis affects my lungs, " she says. " The

weather and allergies make it hard to breathe. I cough. But I still

try to get out and about; I try to leave the house everyday at least

to go grocery shopping. "

" Medical students can learn from me, " Becker comments. " When it comes

to medical treatment, I don't trust anybody. I question a lot. I want

to know why someone's doing something. I want the young doctors to

learn to respect the patient as a thinking person and make time for

them. "

Medical student Guerry will follow Becker's progress over

the next three years. " This long-term experience can give us an

appreciation of being able to have a more in-depth relationship with

a patient, similar to the way physicians used to work within

communities, when they had a real and lasting relationship with their

patients, " said Guerry.

Guerry's first visit with Becker lasted two hours. He learned about

CF and the difficult aspects of the disease Becker has had to live

with and overcome. " Mrs. Becker is wonderfully open and there is so

much we can learn from her personality and strength. The burden of

managing such an illness daily is incredible. I am struck by her

optimism and humor and love of her family. "

Student/Patient Pairing Leads to Patient Advocacy and Better

Doctors... Lipson, MD, Director of the Adult Cystic Fibrosis

program at Penn and who is also involved in the LEAPP program,

notes, " We are bringing the patient into the classroom, so to speak.

It's one thing to read about a disease; it's another to interact with

a patient and see how the disease affects them physically, socially,

financially, and coping in general. "

Holsclaw, MD, Senior Staff Physician with the Adult Cystic

Fibrosis program at Penn Presbyterian Medical Center, who diagnosed

Becker and has been her doctor for the last 25 years, says, " The

medical students in this program get a learning experience here at

Penn -- with all the resources we have and the depth of knowledge of

our physicians -- that they may not get elsewhere. They get to see

firsthand the doctor-patient relationship truly evolve, during which

the doctor is able to continually comfort a patient, and say to

them 'you remember how you made it through that surgery in the past,

you were fine, you bounced back, and you'll be fine this time too.' "

Medical students in the LEAPP program are expected to meet the

patient they are paired with in person, and then follow-up with them

by phone or face-to-face at least every month over a three-year

period. Students are also encouraged to visit their patients when

they are hospitalized, during other doctor visits, and during

outpatient testing. One in-home visit is required. Also, students

must complete written assignments, which focus on the biopsychosocial

aspects of their patient's illness.

In the first year of this experience, students primarily work to form

a relationship with the patient and family. In the second and third

years, students are expected to have the sufficient skills and

knowledge to serve as 'health coaches' for their patients, under the

supervision of the patient's physician.

" We want the students to learn how a patient with a chronic health

condition lives and works... how it affects not only their physical

well-being but also their emotional and spiritual well-being, too, "

explains LEAPP Director Lanken. " We want them to understand this from

the patient's point of view, not the doctor's. We want them to view

their future patients first of all as persons, and learn what it's

like for them to live with their particular condition and how it

affects their family. Bottom line... in the long run, this will teach

our Penn medical students how to be better doctors. "

This program is funded by a generous donation by an anonymous

supporter of better medical education.