A very important and meaningful post and call to action. Physicians hold a trusted and respected place in society and our lives. It maybe slipping a bit thanks to Vax misinformation. Still quite high.
Let me get a bit into the weeds and toss a few drops of cold water on this.
My business, when I had one, was developing CME for physicians and nurses. Working with luminaries to identify educational needs and create learning modules for physicians. The single overriding reality in that work was this, "Physicians don't know what they don"t know."
CME and licensing are meant to bolster the idea physicians are life long learners. Many studies have been done showing that once a physician graduates from residency the learning curve flattens somewhat. CME is meant to upper right knowledge. Hope springs eternal. Many physicians will look to learn when they recognize there is a problem and they don't know a solution. This is not meant to paint physicians w/a wide brush but it is known. Newer physicians seem to be more driven for continuous learning over a life time.
We worked with Dr. HB Slotnick a medical educator. His work back in the 90's exposed the need to teach physicians better so better care can be delivered. He's written extensively. His most import work is "How doctors learn: the role of clinical problems across the medical school-to-practice continuum" https://pubmed.ncbi.nlm.nih.gov/8540958/ He based his study on an adult educator from the 50's Malcolm Knowles.
Knowles posited that adults learn best under the following circumstances:
1. The learning is self-directed.
2. The learning is experiential and utilizes background knowledge.
3. The learning is relevant to current roles.
4. The instruction is problem-centered.
5. The students are motivated to learn.
Number 4 and 5 I've learned are critical to helping physicians engage in learning. They need to see that a problem exists and they have to be motivated to learn how to solve it. No amount of stories on CNN about our mental health crisis is going to motivate a physician to learn. They have to recognize the problem in their practice and recognize they need to learn how to solve that problem.
Case in point. I've been to see my PCP recently. In fact a few times over the past year. He is part of Weill Cornell. They have added to the tome of pre-visit online check in stuff a section on mental health. About 6 questions. Once you get to the office a clip board with about 5 questions. Me being me puckish and all I got brutal and honest. LOL
Spoiler alert. Wait for it. Not once was it looked at or asked about. When I asked he said I don't have anywhere to send someone and the costs are too high.
Bottomline, mental health education for medical professionals is NEEDED! It must be designed to fit the principles of how physicians learn. Identifying problems they face that they may not recognize they have. And they need to feel doing something achieves durable outcomes.
Mark, this is so helpful and could be its own post! Thank you! I struggle with places that ask or assess but then do nothing with that data. It can be damaging. There's a role here to get our medical professionals training and exposure in this space prior to them graduating - an uphill battle, but one worth fighting. As always, thank you for such a thoughtful comment!
Thank you Ben, I totally embrace alternative approaches to providing support in addressing our mental wellbeing. I have been going into schools for the past year bringing in the creative community & nonprofit partners to share alternatives with youth on how to address mental wellness. By all accounts young people welcome the opportunity to both de stigmatize the conversation & are open to alternatives to support thier mental wellbeing. Jackstrong!!
Rick - this great and another good call out that there are many things we can do that help normalize mental health. The more we can get people to see how our mental health is connected to other facets of life, the better we are likely to be at engaging them in strategies that work for them and their mental health!
So much potential here. Park prescriptions, NatureRx, Prescribe-a-bike -- the list goes on and there are some innovators doing this. In some countries (i.e. Canada, the UK recently) there are very blanket policies to provide low-cost or free entrance to parks.
Also worth seeing what Dr. Wes Tate - https://www.colorado.edu/cedar/wes-tate - is doing with nature-based social prescribing and an outpatient therapy program in Boulder, CO open space. Importantly, Wes has figured out some ways to get insurance to cover this programming.
Coming soon(ish) on my substack - Learning by Nature: https://beccakatz.substack.com/ - will be a feature about schools as a site for social prescribing of natureRx through teachers' routine pedagogical practices. Would love to chat this one through with you if you're up for it!
A very important and meaningful post and call to action. Physicians hold a trusted and respected place in society and our lives. It maybe slipping a bit thanks to Vax misinformation. Still quite high.
Let me get a bit into the weeds and toss a few drops of cold water on this.
My business, when I had one, was developing CME for physicians and nurses. Working with luminaries to identify educational needs and create learning modules for physicians. The single overriding reality in that work was this, "Physicians don't know what they don"t know."
CME and licensing are meant to bolster the idea physicians are life long learners. Many studies have been done showing that once a physician graduates from residency the learning curve flattens somewhat. CME is meant to upper right knowledge. Hope springs eternal. Many physicians will look to learn when they recognize there is a problem and they don't know a solution. This is not meant to paint physicians w/a wide brush but it is known. Newer physicians seem to be more driven for continuous learning over a life time.
We worked with Dr. HB Slotnick a medical educator. His work back in the 90's exposed the need to teach physicians better so better care can be delivered. He's written extensively. His most import work is "How doctors learn: the role of clinical problems across the medical school-to-practice continuum" https://pubmed.ncbi.nlm.nih.gov/8540958/ He based his study on an adult educator from the 50's Malcolm Knowles.
Knowles posited that adults learn best under the following circumstances:
1. The learning is self-directed.
2. The learning is experiential and utilizes background knowledge.
3. The learning is relevant to current roles.
4. The instruction is problem-centered.
5. The students are motivated to learn.
Number 4 and 5 I've learned are critical to helping physicians engage in learning. They need to see that a problem exists and they have to be motivated to learn how to solve it. No amount of stories on CNN about our mental health crisis is going to motivate a physician to learn. They have to recognize the problem in their practice and recognize they need to learn how to solve that problem.
Case in point. I've been to see my PCP recently. In fact a few times over the past year. He is part of Weill Cornell. They have added to the tome of pre-visit online check in stuff a section on mental health. About 6 questions. Once you get to the office a clip board with about 5 questions. Me being me puckish and all I got brutal and honest. LOL
Spoiler alert. Wait for it. Not once was it looked at or asked about. When I asked he said I don't have anywhere to send someone and the costs are too high.
Bottomline, mental health education for medical professionals is NEEDED! It must be designed to fit the principles of how physicians learn. Identifying problems they face that they may not recognize they have. And they need to feel doing something achieves durable outcomes.
Sorry I got all ranty
Mark, this is so helpful and could be its own post! Thank you! I struggle with places that ask or assess but then do nothing with that data. It can be damaging. There's a role here to get our medical professionals training and exposure in this space prior to them graduating - an uphill battle, but one worth fighting. As always, thank you for such a thoughtful comment!
Thank you Ben, I totally embrace alternative approaches to providing support in addressing our mental wellbeing. I have been going into schools for the past year bringing in the creative community & nonprofit partners to share alternatives with youth on how to address mental wellness. By all accounts young people welcome the opportunity to both de stigmatize the conversation & are open to alternatives to support thier mental wellbeing. Jackstrong!!
Rick - this great and another good call out that there are many things we can do that help normalize mental health. The more we can get people to see how our mental health is connected to other facets of life, the better we are likely to be at engaging them in strategies that work for them and their mental health!
Thank you for this!
So much potential here. Park prescriptions, NatureRx, Prescribe-a-bike -- the list goes on and there are some innovators doing this. In some countries (i.e. Canada, the UK recently) there are very blanket policies to provide low-cost or free entrance to parks.
Great work here being done by: Dr. Nooshin Razani - https://www.linkedin.com/in/nooshin-razani-987165a6/ - at the Center for Nature & Health at UCSF and Benioff Children's Hospital - https://www.centerfornatureandhealth.org/
Also worth seeing what Dr. Wes Tate - https://www.colorado.edu/cedar/wes-tate - is doing with nature-based social prescribing and an outpatient therapy program in Boulder, CO open space. Importantly, Wes has figured out some ways to get insurance to cover this programming.
And, Dr. Melissa Sunderman -https://www.linkedin.com/in/melissa-sundermann-do-dipablm-226819146/ - is on a mission to have "Daily Time in Nature" be a 7th pillar of lifestyle medicine.
Coming soon(ish) on my substack - Learning by Nature: https://beccakatz.substack.com/ - will be a feature about schools as a site for social prescribing of natureRx through teachers' routine pedagogical practices. Would love to chat this one through with you if you're up for it!