"OK, I was just wondering, why is his blood pressure out of control?" the attending doctor asks. A senior emergency room listens to the resident’s summary of his patient and has some questions. In the conference room, the second of four videos begins.
"As important as checking their blood pressure is probably trying to figure out why their blood pressure is poorly controlled," Schneider says of patients. "It’s as important as anything else you’re going to do." New residents at BMC attend orientation, which includes a workshop on the social determinants of health. Jeff Schneider, who oversees training programs at BMC, added this workshop for all new residents to emphasize the need for a cultural shift among doctors. The pediatrics department at BMC has included a similar simulation for residents for several years. Dr. This year orientation includes a workshop on what's known as social determinants of health. It’s a recognition that where and how people live, their cultural or religious beliefs, their education and income - all these things affect health. This is day two for new residents at BMC. "He didn’t really kind of delve in at all, like why can’t we get the med in you on a normal schedule, what’s the problem, try to evaluate that a little bit," Minsky says.Īsking Better Questions To Better Patients' Health Josh Minsky points out the resident didn’t find out why the patient isn’t taking his medicine as prescribed. He asked yes or no instead of open-ended questions. His new colleagues noticed the doctor did not sit down, a common clinical faux pas. "What was lacking, what was missing in that interaction?" asks Dr. Travis Manasco, a fourth-year resident who’s leading this workshop. The resident checks the patient’s heart rate, breathing, balance and some other things, then excuses himself to consult with a senior emergency room doctor.
"So how often, is that?" the doctor asks. "Whenever I can," the man says with a shrug. "How often would you say you take this medicine?" the resident asks. He doesn't have any medication for headaches, but he does have a prescription for his high blood pressure. He says he comes to the ER with the same problem about every two months. (Jesse Costa/WBUR) This article is more than 5 years old.įourteen young men and women shift their chairs toward a screen on a conference room wall at Boston Medical Center (BMC). As the video begins, a resident in green scrubs walks into an exam room and greets a man slumped on the edge of a hospital bed. Medical personnel enter Boston Medical Center through the emergency entrance gate on Harrison Avenue.