“When you are yourself, I’m free to be myself”

The Reverend Bill Hendry spoke these words as a “first patient” at the First Patient Program’s 3rd annual Grand Finale on Wed. May 13. He was addressing the 100 students of the class of 2017 who had completed their 18 plus months of relationship with their first patient, whom they’d met in September, 2013. Since then, the students in partners have visited 50 first patient/teachers at their homes, during health care visits, at the ER, in support groups and even grocery shopping to learn about the health care journey through the eyes of the patients.

Photo by Wilfred Ip
Photo by Wilfred Ip

Wednesday was a day to focus on the doctor patient relationship for the students. Hosted by Dr. Tony Sanfilippo, the developer and director of the program, the afternoon began with Dr. Leslie Flynn speaking to the students about the trust that is necessary in a doctor patient relationship, and how extraordinary that trust is. She urged students to take the lessons of their first patient experience—the challenges as well as the good times– as they build that trust in their future relationships.

 

Reverend Bill Hendry, first patient and maple syrup maker extraordinaire, and his wife Lorna spoke to the students about the same relationship. Bill and Lorna have been involved in the program since its inception.

Lorna spoke about how when one partner has a chronic illness, both partners have that illness and experience its effects, and how important it is that physicians respond to this.  Bill HendryPhoto by Wilfred Ip

Bill said that his students were very much themselves when they met with the Hendry’s and how much that is appreciated by patients. Patients appreciate the honesty, the care, and the commitment—the trustworthiness of their physician.

Students afterward shared their experiences of their first patients with their teammates. With prompts such as “Challenges” and “Impact” students were able to tell their stories to their classmates. Using Poll Everywhere, students generated a word cloud, where words such as “humbling” “enlightening”, “perspective” and “eye-opening” came to the fore.

FPP_Humbling_WordArt

Then it was time to have a party! Erin Matthias, Kathy Bowes, Jason Kwok (Meds 2017) and Vincent Wu ( Meds 2018) organized a great party—with a wonderful buffet, balloons, music, and many volunteers from the first year class to escort patients to the 2nd floor. We also had a photographer–thanks to Wilfred Ip, Meds 2018 for his excellent photographs used here in this article!

Photo by Wilfred Ip
Photo by Wilfred Ip

About 30 patients, some with family members, several physicians, many of whom have been part of the program since its inception, Dr. Phil Wattam the incoming Director of the program, 100 students in 2nd year meds, 12 volunteers from first year meds, Kathy, Erin, and yours truly mingled in the Lantern Lounge, and several of the rooms on the 2nd floor.

Photo by Wilfred Ip
Photo by Wilfred Ip

I was musing on the doctor/patient relationship too…earlier that morning, Dr. Ingrid Harle had introduced a very provocative article  in the Health Sciences Education Journal Club, called Professionalism: A framework to guide medical education by Brody and Doukas, in Medical Education: 48: 980-987, 2014. The authors wrote, “The concept of the social contract reminds the student that trust involves a two-way relationship. Ideally, trust exists on the patient’s side and trustworthiness on the physician’s. A dedication to professionalism, viewed as character, establishes the conditions for trustworthiness.” And further…

Photo by Wilfred Ip
Photo by Wilfred Ip

“Students will best understand a virtue approach when they are reminded of how hard it is to keep one’s public promise to put the interests of patients first, as the maintenance of public trust requires. To do this not only on good days, but also on bad days when we are tired and irritable and no-one is watching, requires more than simple rules; it requires that we devote ourselves to becoming certain sorts of persons. If students engage in honest reflection, they will agree that little in their previous lives has taught them to be the sorts of persons who routinely put the interests of others first, even if to do so requires some significant sacrifice. If students see that professionalism, properly understood, requires them to grow into the sorts of persons who not only engage in that hard work, but who do so willingly and cheerfully, they then understand what character and virtue have to do with their education.”

Photo by Wilfred Ip
Photo by Wilfred Ip

In one quiet moment during the very successful if hectic afternoon, as I looked around the room, I was thinking of Bill Hendry’s words, of the theme of the professionalism article, and of our goals in UG as we had set out to design this program with our now graduating class of 2015 three years ago. I was looking around at the students helping their patients at the buffet, solicitously helping them to a chair, listening intently to their patients and laughing with them, at the end of a long day and scant days before exams, and I thought, “Whew! We’re ok then. This group of future physicians has got it. Compassion, trustworthiness, the sorts of persons who put the interests of others first–those characteristics are all here in our future physicians at Queen’s.”

Congratulations to the First Patient Program on another successful year…each year you make it better!