| (Philadelphia, PA) - 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 Christopher 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 Paul 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 Christopher 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…
David 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.”
Douglas 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.”
Editor's Note: This program is funded by a generous
donation by an anonymous supporter of better medical education.
###
PENN Medicine is a $2.7 billion enterprise
dedicated to the related missions of medical education, biomedical
research, and high-quality patient care. PENN Medicine consists
of the University of Pennsylvania School of Medicine (founded in
1765 as the nation's first medical school) and the University of
Pennsylvania Health System.
Penn’s School of Medicine is ranked #2 in the nation
for receipt of NIH research funds; and ranked #4 in the nation in
U.S. News & World Report’s most recent ranking of top
research-oriented medical schools. Supporting 1,400 fulltime faculty
and 700 students, the School of Medicine is recognized worldwide
for its superior education and training of the next generation of
physician-scientists and leaders of academic medicine.
The University of Pennsylvania Health System comprises: its
flagship hospital, the Hospital of the University of Pennsylvania,
consistently rated one of the nation’s “Honor Roll”
hospitals by U.S. News & World Report; Pennsylvania Hospital,
the nation's first hospital; Penn Presbyterian Medical Center; a
faculty practice plan; a primary-care provider network; two multispecialty
satellite facilities; and home health care and hospice.
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