Questions Part Three
Q. What do you mean by saying that doctors are the third leading cause of death in the United States?
A. This statement is validated by the July 26, 2000 issue of the Journal of the American Medical Association, Volume 284. These deaths are due to errors made by doctors in the course of their treatment. Most often, these fatalities are the result of a doctor prescribing an inappropriate medication.
Q. Are you suggesting a college "medical major"?
A. No, I am suggesting a free, open system in
which the student
designs his own educational program.
Q. You state that there are a large number of non-profit websites on medical subjects authored by non-physicians. You also state that many of these sites are extremely information rich, and usually more substantive and accurate than the information provided by most physicians. Since anyone with basic HTML skills can create a medical website, how can the layman discriminate between valuable information and nonsense?
A. We are referring to illnesses that are somewhat outside of main stream medicine, such as chronic fatigue syndrome. In these cases it is frequently difficult for both doctors and non-physicians to distinguish which treatments are effective. Furthermore, when dealing with such an illness, everyone responds to treatment differently. In these instances, it is good to be part of a support or discussion group of patients who suffer from that particular condition. Such individuals will provide a lot of valuable input pertaining to treatment options, and will do so without financial motivation, and in an unbiased fashion. Often, these groups will contain some very scholarly people who have studied these medical conditions in depth and are good critical thinkers.
Q. You state that the root-cause of our current healthcare problems resides in our system of medical education. What are the first steps that need to be taken for us to revamp this flawed system?
A. Since the general public does not understand that our system of medical education is at the core of this dysfunction, we must educate them on this matter. We must also educate the existing army of healthcare reform activists, because this concept may be new to them. We need to help such activists focus on root causes, rather than vague symptoms. We need activists to focus on concrete solutions, rather than vague notions. We must pass regulations at the state level that will allow for the creation of an alternative pathway for becoming a doctor, a pathway that we have described. Once one state does this, the rest of the world will follow.
Q. Isn't rote memorization crucial for a medical student to learn the huge volume of knowledge necessary to practice as a physician?
A. Please refer to our page on how memory works. It is difficult to memorize material from books or lecture notes, and even more difficult to retain that information for a long period of time. When the student is seeing live patients, face-to-face, he will read about illnesses and their treatments and associate this knowledge with actual patients. Not only is this a more natural and pleasant learning process, this association process is far more conducive to long term memory.
Q. I take issue with your arguing that the medical establishment should function more along the lines of the Microsoft Corporation. Although Microsoft may be successful and cost-effective, it is brutally competitive and employs deceptive marketing practices. Would you please respond to this?
A. We didn't mean that at all. We said that if Microsoft required competency plus proof of a long, formal educational process, the corporation would not be able to operate in a cost-effective way. We did not say that the medical profession should emulate Microsoft.
Q. In one section of your site you argue that most physicians impatiently prescribe a medication to their patients and bill them at a high fee. Yet in another section you cite the fact that many doctors at teaching facilities donate their time for free. What do you think?
A. Both statements are correct. All doctors are not alike.
Q. In terms of the solution you suggest for improving the medical educational system, isn't the 12 years of education crucially important for students to learn the huge database of knowledge that every doctor must draw upon in helping his patients?
A. Most of the information that the doctor learns in these twelve years is unnecessary and irrelevant to his ultimate practice. Because this knowledge is acquired in the familiar model of memorize, pass the test, and forget, the great majority of it is forgotten by the time that the student begins to practice medicine. It is true that a doctor must have a very large fund of knowledge from which to draw. This knowledge, however, must be relevant, and acquired in such a way that it is committed to long-term memory. The learning must be whole-brain, rather than left-brain learning. Simply put, there is a difference between learning by doing and 'learning' by memorizing words.
Q. Your proposals seem very
revolutionary. Won't it take a very long time to implement them?
A. The public is extremely motivated to find a solution to this vexing problem. This site has aroused a great deal of interest, and ranks high using the search term "health-care reform" in Yahoo, Google, and LookSmart, based on numbers of site visits and links to the site. This is evidence that motivated people are actively exploring this approach.