Blog | Friday, July 8, 2016

Hippocrates and the Internet


The Hofstra Northwell School of Medicine recently graduated its second class. The commencement was a wonderful “feel-good” event, complete with beautiful weather, happy graduates and proud families. The ceremony closed with the newly minted physicians rising to their feet and reciting the oath of the physician. In a nice touch, the other physicians in the audience were invited to renew their commitment to the profession by joining in. I found the whole thing joyous, and the opportunity to publically take the oath again was a moving reminder of what doctoring is all about.

Coincidentally, I also had the opportunity this week to lead one of the sessions in Northwell's Physician Leadership Development Program, part of a half-day session withSven Gierlinger, our organization's Chief Experience Officer, and Jill Kalman, the Medical Director of Lenox Hill Hospital, devoted to the voice of the patient. My bit was about our “transparency project“ to publish our physicians' patient experience scores on our public website. I used the story of how and why we did that as a case study that tied together the themes of physicians driving change and of improving the care we provide to patients and their families.

It was only after the fact that it occurred to me that there was a profound connection between the 2 events.

First, the oath specifically references the value of a therapeutic relationship between the physician and the patient, stating that “there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.” Our efforts to elevate the importance of our patients' experiences, and to encourage our physicians to improve them, is built on this. It is not “just” about providing a better experience; it is that a better experience is integral to healing. On the other hand, that part was not new. I had always known that Hippocratic Oath contained language of this sort.

It was really the next line of the oath that revealed another connection that I hadn't appreciated before:

“I will not be ashamed to say ‘I know not,’ nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.”

Translated to a contemporary context, I take this to mean that we owe it to our patients to honestly report our personal limitations. Put another way, our professional oath as physicians demands that we be transparent about our performance, even if that means that we are called upon to share information that is not flattering. That is exactly the approach we have taken in sharing our patients' ratings and comments—warts and all— for everyone to see.

I suspect that our new graduates, all of whom grew up in a world connected by the Internet, saw these connections before I did.

What do you think?

Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital. He then held a number of senior positions at Mount Sinai Medical Center prior to joining North Shore-LIJ. He is married with two daughters and enjoys cars, reading biographies and histories, and following his favorite baseball team, the New York Yankees, when not practicing medicine. This post originally appeared at his blog, Ausculation.