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Doctors Serving People

Restoring Humanism to Medicine through Student Community Service

Edward J. Eckenfels

Publication Year: 2008

Today's physicians are medical scientists, drilled in the basics of physiology, anatomy, genetics, and chemistry. They learn how to crunch data, interpret scans, and see the human form as a set of separate organs and systems in some stage of disease. Missing from their training is a holistic portrait of the patient as a person and as a member of a community. Yet a humanistic passion and desire to help people often are the attributes that compel a student toward a career in medicine. So what happens along the way to tarnish that idealism? Can a new approach to medical education make a difference? Doctors Serving People is just such a prescriptive. While a professor at Rush Medical College in Chicago, Edward J. Eckenfels helped initiate and direct a student-driven program in which student doctors worked in the poor, urban communities during medical school, voluntarily and without academic credit. In addition to their core curriculum and clinical rotations, students served the social and health needs of diverse and disadvantaged populations. Now more than ten years old, the program serves as an example for other medical schools throughout the country. Its story provides a working model of how to reform medical education in America.

Published by: Rutgers University Press

Contents

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pp. v-vi

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Foreword

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pp. vii-xii

Early on in my position as Dean of Student Affairs at Dartmouth Medical School, I was asked to bring a group of our medical students to meet with Dr. Robert Coles over breakfast. Dr. Coles, the noted author and child psychiatrist, professor of medicine and humanities at Harvard, and recipient of the Pulitzer Prize for his work in documenting the experiences of those children ...

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Acknowledgments

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pp. xiii-xvi

There are so many people who have helped and supported me, it is impossible to acknowledge all of them. There are, however, a few individuals without whose personal commitment it would have been extremely difficult to make the Rush Community Service Initiatives Program (RCSIP) a reality. ...

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Introduction: Humanism in the Time of Technocracy

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pp. 1-11

To paraphrase the great American Revolutionary hero Thomas Paine, these are times that try the soul of American medicine.1 Cost estimates of $2.2 trillion and rising, at least 45 million people uninsured at any given time, and mounting dissatisfaction with the quality of care received have made the existing crisis in medicine increasingly alarming. ...

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Chapter 1: The Emergence of the Rush Community Service Initiatives Program

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pp. 12-29

The impetus for launching the Rush Community Service Initiatives Program came from a first-year course in community health I taught in the late 1980s. The primary aim of the course was simply to get the students outside the walls of the academic health center and into the vast cultural diversity of Chicago’s neighborhoods and communities. The course was a logistical nightmare. Since the majority of transportation to and from the various sites was by car ...

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Chapter 2: Clinics Serving the Poor and Homeless

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pp. 30-64

Although the four clinics serving the poor and homeless shared the common theme of learning from giving service to the underserved and disadvantaged, each one had its own pattern of what these experiences meant to the RCSIP participants and the people they served. The different geographic areas, the unique history of each community, the broad sociocultural variations, and the social order of each clinic or shelter provided settings in which an understanding of the human element of giving care went far beyond simply learning medical procedures and technical skills. ...

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Chapter 3: The New Faces of AIDS

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pp. 65-78

In 1991 I attended a two-day symposium on AIDS at the New York Academy of Medicine. I got an academic rate at a boutique hotel across the street from the Metropolitan Museum of Art on Fifth Avenue. It was a beautiful late summer day, so I decided to walk along Central Park to the academy. Everything was still in bloom, the air was fresh and clear, the sun warm and comfortable; it was one of those perfect days you wish could last forever, ...

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Chapter 4: Community-Based Grassroots Programs

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pp. 79-95

There are two RCSIP programs that are essentially grassroots in nature. One began at Henry Horner Homes, a Chicago Housing Authority project on the Near West Side, and the other at Casa Guatemala, in the Uptown community area on the Far North Side. ...

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Chapter 5: The Community Today, Tomorrow the World

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pp. 96-107

In the 1990s the United States, like the rest of the industrialized world, was going global, and cultural diversity was becoming the norm. The new global perspective was finding its way into health care and medicine: The AIDS pandemic does not stop at the border; people carrying contagious diseases can be in a country thousands of miles away in ten hours. ...

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Chapter 6: Looking for Meaning

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pp. 108-117

Since RCSIP emerged spontaneously, evolving rapidly out of student enthusiasm, it was impossible to prepare any truly systematic evaluation scheme in advance. Yet the questions that are most frequently asked are about evaluation— what kind of controls, if any, were used, what were the outcomes, what measurements were used, what statistical methods were applied—that is, the standard questions found in formal grant proposals that, ...

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Chapter 7: Empirical Estimates of Patients and Clients Served

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pp. 118-125

The task of accounting for those people served by RCSIP is an interesting one. First, on the basis of my decision to limit and discuss in detail four very different and particularly revealing types of programs, I excluded a number of other activities that were just as important to the participants and the people they served. Second, for this assessment I have included all twenty-four programs that had been undertaken during the decade of the 1990s (see table 1). ...

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Chapter 8: The Learning and Development of the Students

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pp. 126-132

When the fifth class with RCSIP representation graduated in 1994, it was possible to try to measure what, if any, effect participation was having on the students’ academic performance. The total number of students who graduated in the five-year period 1990–1994 was 565, of which 176 (31 percent) participated at some level in RCSIP, despite RCSIP being still in its first stage of growth. ...

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Chapter 9: Nurturing Idealism, Advancing Humanism, and Planning Reform

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pp. 133-160

It is time to put what I have said so far into some kind of overarching framework. The four pillars of RCSIP—student initiated, student run, voluntary, and extracurricular—are the sine qua non of the program. An analysis of what constitutes RCSIP during its first decade must necessarily be concerned with an equation embracing at least four major elements: service, learning, values, and community. The biomedical side of the equation is already an established fixture in the formal medical school curriculum. ...

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Chapter 10: A Personal Reflection: The Staying Power of the Call of Service

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pp. 161-172

In March 2000, I was asked to make a presentation on “humanitarianism” at the Ninth International Health in Medical Education Conference in Vancouver, British Columbia. My session was one of four scheduled for this time slot, after lunch on the second day of the conference. Much to my surprise, the room was packed, primarily with medical students from across the United States and Canada. ...

Appendix A: Sources of Funding for RCSIP

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p. 173-173

Appendix B: Guidelines for Maintaining Safety and Security

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pp. 174-175

Appendix C: Publications and Presentations of RCSIP Participants

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pp. 176-180

Appendix D: The Social Medicine, Community Health, and Human Rights Curriculum

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pp. 181-186

Notes

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pp. 187-192

Bibliography

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pp. 193-200

Index

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pp. 201-216

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About the Author

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p. 217-217

Edward J. Eckenfels is an emeritus professor in the Department of Preventive Medicine at Rush University Medical Center in Chicago. During more than thirty years at Rush, he has taught; conducted research; and developed programs in social medicine, community health, and medical education. He has been active in promoting voluntary community service and international ...


E-ISBN-13: 9780813545097
E-ISBN-10: 0813545099
Print-ISBN-13: 9780813543154
Print-ISBN-10: 0813543150

Page Count: 240
Illustrations: 6 tables
Publication Year: 2008

Series Title: Critical Issues in Health and Medicine
Series Editor Byline: Rima D. Apple, Janet Golden