50. Ong et al., “Doctor-Patient Communication”; Heisler et al., “The Relative Importance of Physician Communication”; Schenker et al., “Interventions to Improve Patient Comprehension.”
51. D. Schillinger, J. Piette, K. Grumbach et al., “Closing the Loop: Physician Communication with Diabetic Patients Who Have Low Health Literacy,” Archives of Internal Medicine 163 (2003): 83–90.
52. Schillinger et al., “Closing the Loop.”
53. Ong et al., “Doctor-Patient Communication”; Heisler et al., “The Relative Importance of Physician Communication.”
54. Schenker et al., “Interventions to Improve Patient Comprehension.”
Chapter 5
1. A. H. Maslow, “A Theory of Human Motivation,” Psychological Review 50 (1943): 370–96.
2. I. D. Yalom, The Theory and Practice of Group Psychotherapy, 4th ed. (New York: Basic Books, 1995).
3. A. Windover, A. Boissy, T. Rice, T. Gilligan, V. Velez, and J. Merlino, “The REDE Model of Healthcare Communication: Optimizing Relationship as a Therapeutic Agent,” Journal of Patient Experience 1 (2014): 8–13.
4. B. S. Bloom, Taxonomy of Educational Objectives: The Classification of Educational Goals, 1st ed. (New York: Longmans, Green, 1956).
5. D. Kirkpatrick, “Great Ideas Revisited. Techniques for Evaluating Training Programs. Revisiting Kirkpatrick’s Four-Level Model,” Training and Development 50, no. 1 (1996): 54–59.
6. M. S. Knowles, E. F. Holton, and R. A. Swanson, The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development (Boston: Elsevier, 2005).
7. M. Weimer, Learner-Centered Teaching: Five Key Changes to Practice, 2nd ed. (San Francisco, CA: Jossey-Bass, 2013).
8. W. R. Miller and S. Rollnick, Motivational Interviewing: Preparing People for Change, 2nd ed. (New York: Guilford Press, 2002).
9. P. A. Barrier, J. T. Li, and N. M. Jensen, “Two Words to Improve Physician-Patient Communication: What Else?,” Mayo Clinic Proceedings 78 (2003): 211–14; J. Heritage, J. D. Robinson, M. N. Elliott et al., “Reducing Patients’ Unmet Concerns in Primary Care: The Difference One Word Can Make,” Journal of General Internal Medicine 22 (2007): 1429–33.
10. K. A. Ericsson, “Deliberate Practice and Acquisition of Expert Performance: A General Overview,” Academic Emergency Medicine 15 (2008): 988–94.
11. A. Chapman, “Conscious Competence Learning Model Matrix,” http://www.businessballs.com.
12. W. Taylor, “Medical Education Learning Cycle,” 2007, http://www.businessballs.com/consciouscompetencelearningmodel.htm.
13. J. Luft, Of Human Interaction (Palo Alto, CA: National Press Books, 1969).
14. Services CfMM, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) (Baltimore, MD: Agency for Healthcare Research and Quality).
Chapter 6
1. P. F. Ferrari, “The Neuroscience of Social Relations. A Comparative-Based Approach to Empathy and to the Capacity of Evaluating Others’ Action Value,” Behaviour 151 (2014): 297–313; B. C. Bernhardt and T. Singer, “The Neural Basis of Empathy,” Annual Review of Neuroscience 35 (2012): 1–23; N. Danziger, I. Faillenot, and R. Peyron, “Can We Share a Pain We Never Felt? Neural Correlates of Empathy in Patients with Congenital Insensitivity to Pain,” Neuron 61 (2009): 203–12.
2. B. Edwards and V. Clarke, “The Psychological Impact of a Cancer Diagnosis on Families: The Influence of Family Functioning and Patients’ Illness Characteristics on Depression and Anxiety,” Psycho-oncology 13 (2004): 562–76; Y. J. Hwu, “The Impact of Chronic Illness on Patients,” Rehabilitation Nursing: The Official Journal of the Association of Rehabilitation Nurses 20 (1995): 221–25.
3. T. Wider, “The Positive Image of the Physician in American Cinema During the 1930s,” Journal of Popular Film and Television 17, no. 4 (1990): 139–52.
4. G. Flores, “Mad Scientists, Compassionate Healers, and Greedy Egotists: The Portrayal of Physicians in the Movies,” Journal of the National Medical Association 94 (2002): 635–58.
5. O. Karnieli-Miller, R. M. Frankel, and T. S. Inui, “Cloak of Compassion, or Evidence of Elitism? An Empirical Analysis of White Coat Ceremonies,” Medical Education 47 (2013): 97–108; D. A. Nash, “On the Symbolism of the White Coat,” Journal of Dental Education 78 (2014): 1589–92.
6. Working Party of the Royal College of Physicians, “Doctors in Society: Medical Professionalism in a Changing World,” Clinical Medicine (London, England) 5 (2005): S5–40.
7. Nash, “On the Symbolism of the White Coat.”
8. N. Mathers, N. Jones, and D. Hannay, “Heartsink Patients: A Study of Their General Practitioners,” The British Journal of General Practice: The Journal of the Royal College of General Practitioners 45 (1995): 293–96.
9. N. J. Mathers and L. Gask, “Surviving the ‘Heartsink’ Experience,” Family Practice 12 (1995): 176–83.
10. S. R. Hahn, “Physical Symptoms and Physician-Experienced Difficulty in the Physician-Patient Relationship,” Annals of Internal Medicine 134 (2001): 897–904; P. G. An, J. S. Rabatin, L. B. Manwell et al., “Burden of Difficult Encounters in Primary Care: Data from the Minimizing Error, Maximizing Outcomes Study,” Archives of Internal Medicine 169 (2009): 410–14; E. E. Krebs, J. M. Garrett, and T. R. Konrad, “The Difficult Doctor? Characteristics of Physicians Who Report Frustration with Patients: An Analysis of Survey Data,” BMC Health Services Research 6 (2006): 128; K. Kroenke, “Unburdening the Difficult Clinical Encounter,”Archives of Internal Medicine 169 (2009): 333–34.
11. T. B. Wetterneck, M. Linzer, J. E. McMurray et al., “Worklife and Satisfaction of General Internists,” Archives of Internal Medicine 162 (2002): 649–56.
12. C. Johnston, “Suicide Totals for MDs Sad Reminder of Stresses Facing Medicine, Conference Told,” CMAJ: Canadian Medical Association Journal (journal de l’Association medicale canadienne) 155 (1996): 109–11; C. Reimer, S. Trinkaus, and H. B. Jurkat, “Suicidal Tendencies of Physicians—an Overview,” Psychiatrische Praxis 32 (2005): 381–85; E. S. Schernhammer and G. A. Colditz, “Suicide Rates Among Physicians: A Quantitative and Gender Assessment (Meta-Analysis),” The American Journal of Psychiatry 161 (2004): 2295–302.
13. J. E. Groves, “Taking Care of the Hateful Patient,” New England Journal of Medicine 298 (1978): 883–87.
14. W. F. Baile, L. De Panfilis, S. Tanzi et al., “Using Sociodrama and Psychodrama to Teach Communication in End-of-Life Care,” Journal of Palliative Medicine 15 (2012): 1006–10; W. F. Baile and R. Walters, “Applying Sociodramatic Methods in Teaching Transition to Palliative Care,” Journal of Pain and Symptom Management 45 (2013): 606–19.
15. E. Kübler-Ross, Death: The Final Stage of Growth (Englewood Cliffs, NJ: Prentice-Hall, 1975).
16. W. F. Baile, R. Buckman, R. Lenzi et al., “SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer,” Oncologist 5 (2000): 302–11.
Chapter 7
1. A. Gawande, “Personal Best,” New Yorker, October 3, 2011, 44–53.
2. J. Passmore, Association for Coaching, Excellence in Coaching: The Industry Guide, 2nd ed. (London and Philadelphia: Kogan Page Limited, 2010).
3. Ibid.
Chapter 8
1. K. Sibille, A. Greene, and J. P. Bush, “Preparing Physicians for the 21st Century: Targeting Communication Skills and the Promotion of Health Behavior Change,” Annals of Behavioral Science and Medical Education 16 (2010): 7–13.
2. M. Passiment, H. Sacks, and G. Huang, Medical Simulation in Medical Education: Results of an AAMC Survey (Washington, D.C.: Association of American Medical Colleges, 2011).
3. A. H. Maslow, “A Theory of Human Motivation,” Psychology Review 50 (1943): 370–96; A. H. Maslow, Toward a Psychology of Being (D Van Nostrand Company, 1962).
4. Association of American Medical Colleges, “Applicants and Matriculants Data,” Table 6: Age of Applicants to U.S. Medical Schools at Anticipated Matriculation by Sex and Race/Ethnicity, 2013–2014
and 2014–2015, AAMC, 2015.
5. United States Census Bureau, “Census Bureau Reports ‘Delayer Boom’ as More Educated Women Have Children Later,” 2011.
6. J. Younglaus and J. A. Fresne, Physician Education Debt and the Cost to Attend Medical School: 2012 Update (Association of American Medical Colleges, 2013).
7. F. W. Hafferty, “Beyond Curriculum Reform: Confronting Medicine’s Hidden Curriculum,” Academic Medicine 73 (1998): 403–7.
Chapter 9
1. R. L. Hulsman, W. J. Ros, J. A. Winnubst et al., “Teaching Clinically Experienced Physicians Communication Skills. A Review of Evaluation Studies,” Medical Education 33 (1999): 655–68.
2. K. Donelan, C. M. DesRoches, R. S. Dittus et al., “Perspectives of Physicians and Nurse Practitioners on Primary Care Practice,” New England Journal of Medicine 368 (2013): 1898–906.
3. L. L. Schlitzkus, K. N. Vogt, M. E. Sullivan et al., “Workplace Bullying of General Surgery Residents by Nurses,” Journal of Surgical Education 71 (2014): e149–54.
4. S. Simons, “Workplace Bullying Experienced by Massachusetts Registered Nurses and the Relationship to Intention to Leave the Organization,” ANS. Advances in Nursing Science 31 (2008): E48–59.
5. N. Lipkin, What Keeps Leaders Up at Night: Recognizing and Resolving Your Most Troubling Management Issues (New York: AMACOM, 2013).
6. D. R. Bridges, R. A. Davidson, P. S. Odegard et al., “Interprofessional Collaboration: Three Best Practice Models of Interprofessional Education,” Medical Education Online 16 (2011); M. Hammick, D. Freeth, I. Koppel et al., “A Best Evidence Systematic Review of Interprofessional Education: BEME Guide no. 9,” Medical Teacher 29 (2007): 735–51.
Chapter 10
1. Plato, Charmides, or Temperance, trans. Benjamin Jowett, classics.mit.edu/Plato/charmides.html, accessed 2/4/2016..
2. Ibid.
3. R. P. Kessels, “Patients’ Memory for Medical Information,” Journal of the Royal Society of Medicine 96 (2003): 219–22; National Center for Education Statistics, The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy (U.S. Department of Education, 2006); N. S. Parikh, R. M. Parker, J. R. Nurss, D. W. Baker, and M. V. Williams, “Shame and Health Literacy: The Unspoken Connection,” Patient Education and Counseling 27 (1996): 33–39; M. A. Stewart, “Effective Physician-Patient Communication and Health Outcomes: A Review,” CMAJ 152 (1995): 1423–33.
4. W. Levinson and N. Chaumeton, “Communication Between Surgeons and Patients in Routine Office Visits,” Surgery 125 (1999): 127–34; D. Schillinger, J. Piete, K. Grumbach, F. Wang, C. Wilson, C. Daher, K. Leong-Grotz, C. Castro, and A. Bindman, “Closing the Loop: Physician Communication with Diabetic Patients Who Have Low Health Literacy,” Archives of Internal Medicine 163 (2003): 83–90.
5. Theodore Roosevelt, “Quotation by Theodore Roosevelt,” Dictionary.com, 1910, http://quotes.dictionary.com, accessed April 28, 2015.
6. K. A. Ericsson, “Deliberate Practice and Acquisition of Expert Performance: A General Overview,” Academic Emergency Medicine 15 (2008): 988–94; M. Heisler, R. R. Bouknight, R. A. Hayward, D. M. Smith, and E. A. Kerr, “The Relative Importance of Physician Communication, Participatory Decision Making, and Patient Understanding in Diabetes Self-Management,” Journal of General Internal Medicine 17 (2002), 243–52; M. Hojat, D. Z. Louis, F. W. Markham, R. Wender, C. Rabinowitz, and J. S. Gonnella, “Physicians’ Empathy and Clinical Outcomes for Diabetic Patients,” Academic Medicine 86 (2011): 359–64; F. W. Platt, D. L. Gaspar, J. L. Coulehan, L. Fox, A. J. Adler, W. W. Weston, R. C. Smith, and M. Stewart, “ ‘Tell Me About Yourself’: The Patient-Centered Interview,” Annals of Internal Medicine 134 (2001): 1079–85; Stewart, “Effective Physician-Patient Communication and Health Outcomes”; R. L. Street Jr., G. Makoul, N. K. Arora, and R. M. Epstein, “How Does Communication Heal? Pathways Linking Clinician-Patient Communication to Health Outcomes,” Patient Education and Counseling 74 (2009): 295–301.
7. D. S. Morse, E. A. Edwardsen, and H. S. Gordon, “Missed Opportunities for Interval Empathy in Lung Cancer Communication,” Archives of Internal Medicine 168 (2008): 1853–58.
8. W. Levinson, R. Gorawara-Bhat, and J. Lamb, “A Study of Patient Clues and Physician Responses in Primary Care and Surgical Settings,” JAMA: The Journal of the American Medical Association 284 (2000): 1021–27; A. L. Suchman, K. Markakis, H. B. Beckman, and R. Frankel, “A Model of Empathic Communication in the Medical Interview,” JAMA: The Journal of the American Medical Association 277 (1997): 678–82.
9. R. B. McLafferty, R. G. Williams, A. D. Lambert, and G. L. Dunnington, “Surgeon Communication Behaviors That Lead Patients to Not Recommend the Surgeon to Family Members or Friends: Analysis and Impact,” Surgery 140 (2006): 616–22; discussion 22–24.
10. Levinson and Chaumeton, “Communication Between Surgeons and Patients in Routine Office Visits”; D. L. Roter, G. Geller, B. A. Bernhardt, S. M. Larson, and T. Doksum, “Effects of Obstetrician Gender on Communication and Patient Satisfaction,” Obstetrics & Gynecology 93 (1999): 635–41.
11. A. M. van Dulmen, “Communication During Gynecological Out-Patient Encounters,” Journal of Psychosomatic Obstetrics & Gynecology 20 (1999): 119–26.
12. P. L. Hudak, K. Armstrong, C. Braddock 3rd, R. M. Frankel, and W. Levinson, “Older Patients’ Unexpressed Concerns About Orthopaedic Surgery,” The Journal of Bone and Joint Surgery, American volume 90 (2008): 1427–35.
13. P. A. Barrier, J. T. Li, and N. M. Jensen, “Two Words to Improve Physician-Patient Communication: What Else?,” Mayo Clinic Proceedings 78 (2003): 211–14; J. Heritage, J. D. Robinson, M. N. Elliott, M. Beckett, and M. Wilkes, “Reducing Patients’ Unmet Concerns in Primary Care: The Difference One Word Can Make,” Journal of General Internal Medicine 22 (2007): 1429–33; W. Langewitz, M. Denz, A. Keller, A. Kiss, S. Ruttimann, and B. Wossmer, “Spontaneous Talking Time at Start of Consultation in Outpatient Clinic: Cohort Study,” BMJ: British Medical Association 325 (2002): 682–83; E. Rautalinko, H. O. Lisper, and B. Ekehammar, “Reflective Listening in Counseling: Effects of Training Time and Evaluator Social Skills,” American Journal of Psychotherapy 61 (2007): 191–209.
14. Michael Bliss, Harvey Cushing : A Life in Surgery (New York: Oxford University Press, 2005), xii.
Chapter 11
1. ABIM Foundation, American Board of Internal Medicine, ACP-ASIM Foundation, American College of Physicians–American Society of Internal Medicine, European Federation of Internal Medicine, “Medical Professionalism in the New Millennium: A Physician Charter,” Annals of Internal Medicine 136, no. 3 (February 5, 2002): 243–46.
2. Accreditation Council for Graduate Medical Education, Common Program Requirements, 2013, https://http://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/CPRs2013.pdf, accessed May 30, 2015.
3. C. S. Lesser, C. R. Lucey, B. Egener, C. H. Braddock 3rd, S. L. Linas, and W. A. Levinson, “Behavioral and Systems View of Professionalism,” JAMA: The Journal of the American Medical Association 304, no. 24 (December 22, 2010): 2732–37.
4. B. Egener, “Addressing Physicians’ Impaired Communication Skills,” Journal of General Internal Medicine 23, no. 11 (November 2008): 1890–95.
5. M. K. Wynia, M. A. Papadakis, W. M. Sullivan, and F. W. Hafferty, “More Than a List of Values and Desired Behaviors: A Foundational Understanding of Medical Professionalism,” Academic Medicine 89, no. 5 (May 2014): 712–14; C. Lucey, W. Souba, “Perspective: The Problem with the Problem of Professionalism,” Academic Medicine 85, no. 6 (June 2010): 1018–24.
6. A. K. Windover, A. Boissy, T. W. Rice, T. Gilligan, V. J. Velez, and J. Merlino, “The REDE Model of Healthcare Communication: Optimizing Relationships as Therapeutic Agents,” Journal of Patient Experience 1, no. 1 (2014): 8–13.
7. Committee on Quality of Health Care in America, Crossing the Quality Chasm: A New Health System for the 21st Century (Institute of Medicine, 2001).
8. J. D. Clough, P. G. S
tuder, and S. Szilagyi, To Act as a Unit: The Story of Cleveland Clinic, 5th ed. (Cleveland, Ohio: Cleveland Clinic Foundation, 2011).
9. T. Cosgove, “A Healthcare Model for the 21st Century: Patient-Centered, Integrated Delivery Systems,” Group Practice Journal 60, no. 3 (2011).
10. We thank Nicholas Smedira, MD, for his contribution to the background on the Physician Conduct Committee.
11. The Joint Commission, “Behaviors That Undermine a Culture of Safety,” Sentinel Event Alert 40 (July 9, 2008): 1–3.
12. A. L. Suchman, P. R. Williamson, D. K. Litzelman et al., “Toward an Informal Curriculum That Teaches Professionalism. Transforming the Social Environment of a Medical School,” Journal of General Internal Medicine 19, no. 5, pt. 2 (May 2004): 501–4; R. M. Frankel, “Professionalism,” in M. Feldman and J. Christensen, eds., Behavioral Medicine: A Primary Care Handbook, 3rd ed. (Appleton and Lange, 2008), 424–430; A. H. Cottingham, A. L. Suchman, D. K. Litzelman et al., “Enhancing the Informal Curriculum of a Medical School: A Case Study in Organizational Culture Change,” Journal of General Internal Medicine 23, no. 6 (June 2008): 715–22.
13. G. R. Bushe and A. F. Kassam, “When Is Appreciative Inquiry Transformational: A Meta-Case Analysis,” Journal of Applied Behavioral Science 41, no. 2 (2005): 161–81; N. May, D. Becker, and R. M. Frankel, eds., Appreciative Inquiry in Healthcare: Positive Questions to Bring out the Best (Brunswick, OH: Crown Custom Publishing, 2011).
14. D. L. Cooperrider and D. K. Whitney, Appreciative Inquiry: A Positive Revolution in Change, 1st ed. (San Francisco, CA: Berrett-Koehler, 2005); M. Plews-Ogan, N. May, J. B. Schorling et al., “Appreciative Inquiry and Graduate Medical Education,” ACGME Bulletin, November 5–8, 2007.
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