The Making of a Doozie Doctor

It has always intrigued me that new doctors can be such doozies – now Adam Grant, writing in the New York Times corroborates and explains my observation.

Is Your Doctor a Doozie?

When I worked for Pratt Medical Center, in Fredericksburg, VA, we recruited newly minted doctors from time to time. Obviously these ambitious young bloods had to be smart, work hard, do well to get through high school/college/medical school/residency/maybe even fellowship. 

So how could it be that they could be such dorks when they got out in the real world? 

One new recruit had a patient in the ICU who was just started on the blood thinner, Coumadin. 

Coumadin is a pain because you have to carefully and frequently measure the “protime” to see how thinned the blood is -– especially when starting on it. 

Too much and you bleed out or have a stroke. Too little and you get blood clots.

This newbie sent the patient home with a bucket full of Coumadin and told them to “come back for a protime in a month.” Maybe the doctor couldn’t find an algorithm, but common sense should have kicked in.

Or the stories you hear of getting the decimal point in the wrong place when drawing up a dose of adrenalin – and not wondering at the fact that it took two syringes full to get to the needed dose.

Strait–A  Failures

Organizational Psychologist Dr. Adam Grant claims job performance, and properties such as creativity, leadership and teamwork skills, or social, emotional and political intelligencedo not correlate with academic achievement and good grades. 

I would add common sense as a kind of composite of all of these.

He cites studies that "demonstrated low positive relationships between academic aptitude and/or grades and accomplishment.

And, in particular, that predictions of occupational performance from academic indexes was not significant in MD’s and PhD’s – in fact “indicators such as grades and test scores account on average for only 2.4% of the variance in occupational performance criteria such as income, job satisfaction, and effectiveness ratings.”

“Straight-A students master cramming information and regurgitating it on exams” notes Grant, but “career success is rarely about finding the right solution to a problem — it’s more about finding the right problem to solve.”

Too Much of This

He also talks about experience of employees at Google and a lesson that I was always telling to my daughters when they were in school and fretting about their grades, that “once employees are two or three years out of college, their grades have no bearing on their performance.” Nor on getting good jobs, or career advancement. Everyone looks at your previous job performance instead.

A Culture of “Knowledgism”

I have always complained that the medical profession is plagued by the prejudice of “knowledgism” – that ones entire worth is judged by how much you know. How many factoids you are able to regurgitate.

This my be sour grapes as someone who is not academic by nature and the worst exam taker in the world. But determining medical school entrance almost exclusively on grades, takes no account of communications and listening skills, common sense, empathy and all those touchy-feely characteristics that make a good doctor.

I guess they’re just too hard to measure so we finish up with the kind of doozies that got recruited to our medical group.

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