Feb

14

Violating Patient Privacy in Order to Gain Clinical Experience

Posted by: Mel · 02.14.2013 @ 6:00 pm ⋅ 5 Comments

This is a reaction post to “Is Physician “Shadowing” a Shady Practice?“, an article written by Elizabeth Kitsis, M.D. a bioethics professor at Albert Einstein College of Medicine.

Photo Credit: University of Florida Arts in Medicine Program

I shadowed physicians as a pre-medical student but not as a high-school student because I believed that was far too young for me. Plus, in high school I had watched various shows on Discovery Health about physicians or shows starring physicians. It was one of the few means to awareness about the medical profession that I had legal access. However, my grandmother became ill when I was 17 and I took a strong interest in her medical care. Her untimely death was emotionally devastating but the experience confirmed my decision to continue to pursue medicine.

In college, I searched for opportunities to shadow physicians or work in a medical office to simultaneously obtain clinical experience and pay for things like groceries or school supplies. The reason I shadowed/worked for physicians was because I needed “clinical” experience that would be deemed acceptable by a medical admissions committee. What if I said, “Well, my grandma died and I watched hours of Discovery Health television programs and now I want to be a doctor”? If someone told you that during a medical school interview, would you consider that acceptable “clinical experience”? Yes, there are several ways that one can obtain clinical experience but what is the right way? Meaning, what do hopeful students need to do so that they can get a shot at attending medical school?

Today, it is becoming increasingly difficult to get clinical experience because of privacy for patients and the level of comfort that physicians have with students tagging along on their day-to-day activities. It is especially difficult if you are a student with zero ties to any medical professions (physicians, nurses, therapists, etc). This is understandable because not everyone has parents or relatives as medical professionals and there are numerous ethical dilemmas that arise from shadowing or talking to your relatives about their patients. But for students looking for clinical experience it is not an excuse that can be used when applying to medical school.

Volunteering in an ER or hospice is probably the most watered down version of clinical experience available. Because of strict adherence to HIPAA and professional guidelines for patient care. For example, I remember being able to take vital signs for both adult and pediatric patients under the supervision of the triage nurse. Then one day, a volunteer who was 16 years old, incorrectly reported the blood pressure and pulse oximetry of a patient and the hospital was in trouble. Ever since then, the volunteers were only allowed to stand against the wall and watch. We were lucky that the program was not dissolved altogether.

Now, the most that a volunteer can do is place a pair of hospital socks and a blanket at a bedside since many patients may be unable/unwilling to speak or they may be with family members who do not want someone who isn’t a medical professional making conversation. This has happened to me as a volunteer and I realized then that I will not have any real clinical experience until I actually become a physician.

For someone who is already a physician, Dr. Kitsis has probably become more far removed from the goals and ambitions of the pre-medical/post-baccalaureate student population. What concerns them when they write their personal statements and submit their various clinical experiences through the AMCAS may not be of concern to her since she receives the students after they have by passed these steps to admissions to medical school. As a whole, the further away we get from where we used to be, the more likely we are to forget the challenges once faced.

I wish that Dr. Kitsis would know that there are students like me who have zero ties to the medical profession but are continually inspired by people like her. For one to discourage the plight of hopeful students who wish to shadow physicians is unfortunate but it is not a deterrent. If you are interested in pursuing medicine, you cannot leave any stone unturned when it comes to learning more about the profession. This means understanding the ethical dilemmas that could arise simply from your interest in seeing physicians interacting with patients.

Footnotes

1. Image of Female Doctor with Student from “How to shadow a doctor? Shadowing a doctor the right way” by Don Osborne