Voices From the Past.
Reprinted from the Greater Kansas City Medical Bulletin, May 14, 1966.


REGIMENTATION OF MEDICAL PRACTICE


There was a time when a physician need answer only to his God and his conscience. Whatever the shortcomings in his knowledge or training, yesterday’s doctor was Captain of the Medical Ship. His word was Law.

Those days are gone forever. The social and economic revolution of the past decade has had profound effects on medical practice. The most disturbing of these is the speed with which the control of medicine is passing from private to public hands.

Today’s doctor finds his practice supervised not only by the Local, State and Federal governments, but by a myriad of professional organizations as well. The AMA. The AHA, the ACP, the ACS, etc, etc, ad nauseum. All have their rules and regulations. There is no hospital worthy of the name with less than fifteen standing committees for the sole purpose of regulating the professional activities of its staff.

On July 1, 1966, a large segment of our population will come under federally regulated Medicare. If today’s trends are any indication of the future, tomorrow’s physicians will be practicing in an environment of even greater regulation and control. Furthermore, they will be subjected to regimentation of another type which may prove to be the greatest challenge of all. They will have to cope with the unyielding discipline of new knowledge and technology increasing at rates so fast that even computers can’t keep up.
As our society becomes more complex, we realize that a certain amount of regimentation is inescapable. Some may even be necessary. Unfortunately, much of it is simply the reflection of the bureaucratic thinking of our times.

Is there any hope for the future? In my opinion, there is and it lies in the simple fact that medicine will always be a private relationship between the doctor and the patient. Regardless of the system of medical practice, people will continue to seek doctors in search of relief from their physical and emotional ailments. They have the right to expect the physician to be a human being, sympathetic to their problems, and whose primary concern is for their welfare. Doctors would do well to remember this and not allow their anger and resentment of the system to interfere with their best medical judgement.

Until better criteria are developed, the patient can do worse than trust the doctor who answers to his God and his conscience.

Sherman M. Steinzeig, MD
Editorial Board Representative
Wyandotte County Medical Society

Mentoring

What is a mentor? According to Webster , he is "a faithful and trusted counselor or guide”. Then what is a "docent? It is defined as “ 1) teacher or lecturer and 2) a person who leads a guided tour”. In general, mentoring is usually considered to be a relationship of a minimum of 2 years. The docent concept as practiced at UMKC Medical School could therefore partially qualify as mentoring based on these definitions.

Being a good teacher does not automatically mean than one will be a good mentor. Teaching is the imparting of knowledge and the most successful teachers have occupational skills in their ability to present new knowledge with enthusiasm and flair.. Some of the techniques involved were covered in the Metro Med Bulletin. Chances are that the most revered teacher in your memory was both a good teacher and a good mentor paragraph

Mentoring in medical school and in post graduate training is considered adult mentoring and is distinctly separate from the techniques of the mentoring of children.. At present, the average medical teacher is most likely using the style one uses with children. Children are used to being told what to do, but this direct approach may not set well with advanced students and residents. The "drill sergent” approach at present could result in harassment charges against the teacher.

Resident learning is linked to what they need to know or do in order to fulfill their roles and responsibilities. They are striving for acceptance from peers and staff. They are anxious to prove that they "know something" and to show off their recently hard-gained knowledge. They are trying to shift from being subject-centered to being problem- centered.

The best way to help them become problem solvers is through questioning. When they ask for advice, the mentor should ask their opinion before responding. Some of the best mentors answer every question with a question. If the answer is fuzzy, they tell the student that he needs to "think more about it".

The areas of mentoring are. 1) education, 2) career, and 3) personal development. Educational mentoring involves inculcating the concept of being a perpetual student and the monitoring of knowledge by refresher courses, conferences and meetings. Career mentoring helps guide the student into a career for which he or she is most suited and , in residents, the necessary skills and competencies needed. Personal development mentoring guides decision-making and provides support during times of personal or social stress.

Simply stated, mentoring is the guiding of the development of the whole person. A basic grasp of the scope of mentoring is nicely presented by the work of Ned Herrmann and his “whole brain” concept. The Herrmann system classifies thinking processors into four distinct categories: A) logical, analytical and factual, B) structural, detailed, sequential C) empathetic, emotional and expressive D) conceptual, integrative, synthesizing. A good mentor would have a balanced distribution of the characteristics and use the competencies interchangeably. The scientific curriculum in medicine leans heavily on the A-B areas with emphasis on A characteristics, particularly in specialties.. Therefore, because of his lack of strength in the C and D areas, a typical specialist will have difficulty in truly mentoring a resident.

This makes specialties such as surgery, cardiovascular and gastroenterology. essentially apprenticeships, defined as "one bound by legal agreement to serve another for a certain time with a view toward learning an art or trade in consideration of instruction". Nowadays, the “apprentice” insists on a salary rather than trading his work for training and mentoring. Unfortunately, this causes consternation among those who give time to uncompensated teaching and mentoring.

Yet there are still those who love to teach and seem to have a calling. For them to feel fully rewarded, they should take a course in adult mentoring. It would improve the teacher, the student and the institution

Submitted 4/17/2009
C.Y. Thomas, MD

Minutes of the Meeting of Feb 3, 2009

The Officers and Board of Directors of the John Locke Society of Greater Kansas City, convened at 9:30 AM on Tuesday, Feb 3, 2009 at the home of Keith Ashcraft.

Present were: Keith W. Ashcraft,MD, Don Blim, MD, Sherman M. Steinzeig, MD, Marjorie Sirridge, MD, Walter Stelmach, MD, and Chris Thomas, MD, Ron Youmans, MD, The minutes of the meeting of Jan 6, 2009, were read and approved.

Agenda Item 1: Jazz Night, Feb 21, 2009, 7-10 PM at Hallbrook Country Club, 11200 Overbrook Road, Leawood, KS. This event benefits the Sirridge Office of Medical Humanities and Bioethics. For information and reservations contact Pesto at 816-235-5882 or PestoM@umkc.edu. The deadline for RSVP is Feb 6.

Agenda Item 2: Dr. Stelmach has arranged a demonstration program for the, “Talking With Doctors” project. It will be held at 11:00 AM, on Friday, Feb 20, 2009 at the Presbyterian Church at 78th and Holmes. Drs. Sirridge and Steinzeig will assist Dr. Stelmach.

Agenda Item 3: The Gold Humanities Honor Society of KU will hold a luncheon at KU on Friday, April 17, 2009. Time and place to be announced. Interested members are invited to attend. The GHHS annual induction ceremony will be held at KU at 5:00 PM the same day.
Please let Dr. Steinzeig know if you wish to attend either event.


Agenda Item 4: A JLS luncheon will be held in March. Time and place to be announced.


Agenda Item 5: It was felt that an effort should be made to make better use of our blog and websites to reach our members and invite their participation. We will use the Bulk E-Mail list and articles in the Metromed Bulletin to try to do this.

Agenda Item 6: It was noted that there have been several books published recently that would be of interest to our members.

1) Critical, Tom Dashle
2) La Clinca, David Sklar
3) Why Bull Elephants Fight, Roger Youmans, MD

The meeting adjourned at 10:45 AM.


Signed: ___________________________________ Date: Feb 3, 2009
Sherman M. Steinzeig, MD Secretary

501 (c)(3) Incorporation

As of July 2, 2008, The John Locke Society of Greater Kansas City has been incorporated as a 501 (c)(3), non-profit organization.
The By-Laws and Articles of Incorporation documents are up on the Internet. Go to www.myjohnlocke.com . Select the Primary Website. You will see menu headings for these items. Click and you are there.
Now you can donate all the money you wish with the complete assurance that it will be fully tax deductible. Isn't that wonderful news!

UMKC School Volunteers

At a luncheon meeting on June 13, 2008, nine
first year UMKC medical students were inducted into the John Locke Society Medical Student
Outreach program. Top to bottom they are:

Amal Abukar
Erin Burns
Chen Thay Chau
Jason Edwards
Wesley Glick
Megan Mayer
Ryan Meintz
Maleeha Mohiuddin
Chris Morrison

Patio Party

On Wed, June 4, the John Locke Society had a patio party at the home of Dr. and Mrs Keith Ashcraft. There was plenty of food, drink and good company. About 60 people attended including 3 of our Medical Outreach students. This was fun. We ought to do it more often.

Don Blim Interview of May 13, 2008

The JLS interview of Dr. R.Don Blim is now up and running on the website and ready for viewing. Dr. Blim is a retired Pediatrician and former Director of St. Luke's Hospital in Kansas City. He is also a Member of the Board of Directors of the John Locke Society of Greater Kansas City. There are 6 short video clips. If you want to see them, click here or go to http://www.myjohnlocke.com/ and select the website for videos.