Pauline W. Chen: A Surgeon's Reflections

The Hidden Curriculum of Medical School

In 1994, medical sociologist F.W. Hafferty coined the term, "the hidden curriculum," to describe those lessons which fall outside of the more formal curriculum of medical school and residency .  Medical students and junior residents observe and learn from the behaviors and attitudes of more senior doctors, and the lessons imparted are frequently sobering, sometimes even cynical.  A belief that underscores many of the lessons of the hidden curriculum is simply this: each doctor is born with a fixed ability to be compassionate.

In other words, as one physician-teacher once told me, "You either have it or you don't."

A study in this month's issue of Academic Medicine proves that even established physician-teachers can improve their humanistic skills and become better role models. But, according to the study's lead author, these teachers "would have to believe that such work was important."

You can read more about this study and the hidden curriculum in this week's "Doctor and Patient" column. Please leave any comments you might have below or at Tara Parker-Pope's "Well" blog.

Building a Healthy Community, One Child at a Time

For the last 17 years, North Carolina has had an extraordinary program in place for its neediest children. Community Care of North Carolina provides coordinated, patient-centered care to thousands of low-income children while saving taxpayers millions of dollars.

It's a program that makes me very hopeful but that also requires tremendous commitment from physicians, government administrators and state legislators.

In this week's "Doctor and Patient" column, I write about Community Care of North Carolina. Please contribute to the discussion on Tara Parker-Pope's "Well" blog.

Putting a Price on Compassion

Last week while driving in the car, I heard about Dr. Richard Batista, the Long Island surgeon who is suing his wife for either the kidney he donated to her or the $1.5 million he believes it is worth. 

A few hours later at a dinner, one of the guests asked me if returning the kidney was even possible.

I have to confess that I had asked myself the same question and had wondered how Dr. Batista and his medical expert came up with as high a figure as they had.

In this week's "Doctor and Patient" column, I write about how the Batista saga -- and our reactions to it -- reflect the increasing importance of money in medicine. I hope you have a chance to read the piece and leave your thoughts on the topic at Tara Parker-Pope's "Well" blog.