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The Physician as Teacher
Mayo Clin Proc, November 1987, Vol 62
authors contend the plaintiff's lawyer will use to ensnare him. The authors treat the plantiff's lawyer as the enemy who will give no quarter and will take every conceivable unfair advantage. As a consequence of this and other matters referred to subsequently, the book is not likely to receive high marks from the legal community. Although the book is relatively short (152 pages, including glossary and index), numerous subjects are covered that might possibly relate to, or be of interest to, those involved in a deposition of this type. The authors clearly have spent a great deal of time and given considerable thought to their subject, but I found myself debating the question of how the book might most appropriately be used and by whom it should be used. Without question, the book is designed for the defendant physician himself and it contains much helpful information and many useful suggestions for the defendant physician. I suspect, however, that the results of a poll of malpractice defense lawyers would reveal that many such lawyers would not recommend the reading of this book by their clients. I believe the numerous suggestions that the physician inject himself into the legal conduct of the defense would worry most defense lawyers. (The following are a few examples: "Tell your attorney to object to frequent coaching" [p 32]; "Tell him you expect him t o . . . " [p 47]; "... make sure he's performing the t a s k s . . . " [p 51]; "If he doesn't object... take a short break and ask him why" [p 63]; "Ask your attorney to object to this audience..." [p 91].) Some physicians who read this book also might be so frightened by the prospect of giving their depositions or be so overwhelmed by the suggestions of what is necessary to prepare oneself for this ordeal that it could have an unfavorable effect on their ability to cope with being a defendant in this type of suit. (Some examples are captions such as, "Your deposition is a dangerous experience," "The trial lawyer's 'deadly weapon,' " and "Most questions from the opposition are traps" and suggestions that to be able to withstand the rigors of the deposition the physician should "take training in relaxation therapy," "set aside time for rehearsing your deposition over several months," and "devote at least half an hour every other day to physical conditioning.") The authors even suggest that the physician should, if "ordered to defend yourself in a deposition on short notice" and a delay
BOOK REVIEWS
1072
cannot be arranged, "stay in bed, call in sick if you have to, but don't go unprepared." I believe many defense lawyers also would be concerned about the plaintiff's lawyer discovering that the defendant physician had read this book before his deposition. (Defendant physicians usually are asked what they have read to prepare for their depositions or testimony.) Some of the physician's answers and actions at the deposition might be tied to suggestions in the book, many of which could be considered by judges and jurors to represent questionable conduct. For the reasons stated, I have some reservations about the wisdom of a defendant physician reading this book in preparation for his deposition, but it probably would make interesting, if somewhat frightening, reading for physicians generally. Although the authors have not so intended, I believe that defense lawyers—and, alas, plaintiffs' lawyers also—would find that this book provides numerous reminders of ways to prepare (or question) the defendant physician for (or at) the discovery deposition. Gregg S. K. Orwoll, J.D. Legal Department
The Physician as Teacher, by Thomas L. Schwenk and Neal A. Whitman, 203 pp, with illus, $21.50, Baltimore, Williams & Wilkins, 1987 As the authors explain in their preface, the purpose of this book is to help the physician become a better teacher. This purpose is fulfilled admirably, as I found many valuable tips to improve the physician's teaching ability, whether it pertains to patients, nursing staff, medical staff, or graduate students. Despite a 25-year career spent in academic medical centers, I found that my own approach to teaching has overlooked many important aspects mentioned in this book. This small book, easily read in two evenings, begins appropriately with a section on teaching as a form of communication. In this material, readers are reminded of the many intricate skills to be mastered in effective communication, and I was pleased to see one of my favorite "how-to" books mentioned—Gordon's Parent Effectiveness Training.
Mayo Clin Proc, November 1987, Vol 62
The n e x t a n d major section outlines t h e five t e a c h i n g responsibilities of the physician: lectures, group discussions, t e a c h i n g r o u n d s a n d m o r n i n g report, bedside teaching, a n d outpatient teaching. T h i s style undoubtedly reflects t h e aut h o r s ' own careers in the t e a c h i n g of family practice a n d concentrates on h u m a n i s t i c behaviors such a s e m p a t h y , encouragement, advocacy, a n d respectful listening. These characteristics are i n s t a n t l y recognizable a s h a l l m a r k s of successful p a r e n t s , politicians, clergy, m a n a g e r s , a n d all who deal with people—and, a s I t h i n k back on it, are often in short supply in academic centers t h a t m a y prize intellectual t o u g h n e s s more t h a n h u m a n gentleness, scholastic brilliance more t h a n w a r m t h , a n d research productivity more t h a n c o m m u n i c a t i o n skills. I especially recommend t h e section on medical education in the outpatient setting because t h i s occupies a n increasing s h a r e of education a s each year passes. In this setting, t h e a u t h o r s recommend a s a major goal for teacher a n d s t u d e n t to be "capable, sensitive, enthusiastic, a n d g e n u i n e . " T h i s is timely advice for everyone in the field of medicine. E d w a r d G. Lufkin, M.D. Division of Endocrinology/Metabolism a n d I n t e r n a l Medicine
BOOKS RECEIVED Coronary Artery Surgery in the Nineties, edited by Felix Unger, 264 pp, with illus, $80.60, New York, Springer-Verlag, 1987 Handbook of Office & Ambulatory Gynecologic Surgery, edited by Philip D. Darney, 226 pp, with illus, $42.95, Oradell, New Jersey, Medical Economics Books, 1987 Sickle-Cell Anemia and Thalassemia: A Primer for Health C a r e Professionals, by R. G. Huntsman, 219 pp, with illus, $10, P.O. Box 13156, Station A, St. John's, Newfoundland, Canada AlB 4A4, Canadian Sickle Cell Society, 1987 Avery's Drug Treatment: Principles and Practice of Clinical Pharmacology and Therapeutics, 3rd ed, edited by Trevor M. Speight, 1,507 pp, with illus, $60, Baltimore, Williams & Wilkins, 1987
BOOK REVIEWS
1073
The Dynamic Web of Supracortical Consciousness, by Asok Kumar Mukhopadhyay, 167 pp, with illus, $20, Old Mission Road, Bankura, West Bengal, Pin 722101, India, Sri S. K. Mukhopadhyay, 1987 Innovation and Acceleration in Clinical Drug Development, edited by Louis Lasagna and Alexander G. Beam, 170 pp, with illus, $49.50, New York, Raven Press, 1987 Neurotoxins and Their Pharmacological Implications, edited by Peter Jenner, 297 pp, with illus, $45, New York, Raven Press, 1987 Traumatic Brain Edema (Fidia Research Series, Vol 8), edited by F. Cohadon, A. Baethmann, K. G. Go, and J. D. Miller, 186 pp, with illus, $35, Padova, Italy (distributed by Springer-Verlag, New York), 1987 Stroke, by Clark H. Millikan, Fletcher McDowell, and Donald J. Easton, 341 pp, with illus, $48.50, Philadelphia, Lea & Febiger, 1987 Anxious Depression: Assessment and Treatment, edited by Giorgio Racagni and Enrico Smeraldi, 233 pp, with illus, $29.50, New York, Raven Press, 1987 Prenatal Ultrasound: A Color Atlas With Anatomic and Pathologic Correlation, by Beverly A. Spirt, Lawrence P. Gordon, and Michael Oliphant, 148 pp, with illus, $70, New York, Churchill Livingstone (distributed by Longman, White Plains, New York), 1987 Sjögren's Syndrome: Clinical and Immunological Aspects, edited by Norman Talal, Haralampos M. Moutsopoulos, and Stuart S. Kassan, 229 pp, with illus, $100, New York, Springer-Verlag, 1987 Gastritis: A Critical Review, by Rodolfo Cheli, Alessandro Perasso, and Attilio Giacosa, 242 pp, with illus, $79.50, New York, Springer-Verlag, 1987 Clinical Hematology Illustrated: An Integrated Text and Color Atlas, by Victor A. Hoffbrand and John E. Pettit, 248 pp, with illus, $95, Philadelphia, W. B. Saunders Company, 1987 Code Blue: Cardiac Arrest and Resuscitation (Saunders Blue Books series), edited by Mickey S. Eisenberg, Richard O. Cummins, and Mary T. Ho, 244 pp, with illus, $18.95, Philadelphia, W. B. Saunders Company, 1987 Drug Treatment of the Rheumatic Diseases, 3rd ed, edited by F. Dudley Hart, 229 pp, with illus, $48, Baltimore, Williams & Wilkins, 1987 High-Protein Oedemas and the Benzo-Pyrones, by John R. Casley-Smith and Judith R. Casley-Smith, 536 pp, with illus, $49.50, Philadelphia, J. B. Lippincott Company, 1986 Cardiovascular Drug Therapy, edited by Stephen N. Hunyor, 309 pp, with illus, $60, Baltimore, Williams & Wilkins, 1987 Epidemiology in Medicine, by Charles H. Hennekens and Julie E. Buring, 383 pp, with illus, $19.50, Boston, Little, Brown and Company, 1987
authors contend the plaintiff's lawyer will use to ensnare him. The authors treat the plantiff's lawyer as the enemy who will give no quarter and will take every conceivable unfair advantage. As a consequence of this and other matters referred to subsequently, the book is not likely to receive high marks from the legal community. Although the book is relatively short (152 pages, including glossary and index), numerous subjects are covered that might possibly relate to, or be of interest to, those involved in a deposition of this type. The authors clearly have spent a great deal of time and given considerable thought to their subject, but I found myself debating the question of how the book might most appropriately be used and by whom it should be used. Without question, the book is designed for the defendant physician himself and it contains much helpful information and many useful suggestions for the defendant physician. I suspect, however, that the results of a poll of malpractice defense lawyers would reveal that many such lawyers would not recommend the reading of this book by their clients. I believe the numerous suggestions that the physician inject himself into the legal conduct of the defense would worry most defense lawyers. (The following are a few examples: "Tell your attorney to object to frequent coaching" [p 32]; "Tell him you expect him t o . . . " [p 47]; "... make sure he's performing the t a s k s . . . " [p 51]; "If he doesn't object... take a short break and ask him why" [p 63]; "Ask your attorney to object to this audience..." [p 91].) Some physicians who read this book also might be so frightened by the prospect of giving their depositions or be so overwhelmed by the suggestions of what is necessary to prepare oneself for this ordeal that it could have an unfavorable effect on their ability to cope with being a defendant in this type of suit. (Some examples are captions such as, "Your deposition is a dangerous experience," "The trial lawyer's 'deadly weapon,' " and "Most questions from the opposition are traps" and suggestions that to be able to withstand the rigors of the deposition the physician should "take training in relaxation therapy," "set aside time for rehearsing your deposition over several months," and "devote at least half an hour every other day to physical conditioning.") The authors even suggest that the physician should, if "ordered to defend yourself in a deposition on short notice" and a delay
BOOK REVIEWS
1072
cannot be arranged, "stay in bed, call in sick if you have to, but don't go unprepared." I believe many defense lawyers also would be concerned about the plaintiff's lawyer discovering that the defendant physician had read this book before his deposition. (Defendant physicians usually are asked what they have read to prepare for their depositions or testimony.) Some of the physician's answers and actions at the deposition might be tied to suggestions in the book, many of which could be considered by judges and jurors to represent questionable conduct. For the reasons stated, I have some reservations about the wisdom of a defendant physician reading this book in preparation for his deposition, but it probably would make interesting, if somewhat frightening, reading for physicians generally. Although the authors have not so intended, I believe that defense lawyers—and, alas, plaintiffs' lawyers also—would find that this book provides numerous reminders of ways to prepare (or question) the defendant physician for (or at) the discovery deposition. Gregg S. K. Orwoll, J.D. Legal Department
The Physician as Teacher, by Thomas L. Schwenk and Neal A. Whitman, 203 pp, with illus, $21.50, Baltimore, Williams & Wilkins, 1987 As the authors explain in their preface, the purpose of this book is to help the physician become a better teacher. This purpose is fulfilled admirably, as I found many valuable tips to improve the physician's teaching ability, whether it pertains to patients, nursing staff, medical staff, or graduate students. Despite a 25-year career spent in academic medical centers, I found that my own approach to teaching has overlooked many important aspects mentioned in this book. This small book, easily read in two evenings, begins appropriately with a section on teaching as a form of communication. In this material, readers are reminded of the many intricate skills to be mastered in effective communication, and I was pleased to see one of my favorite "how-to" books mentioned—Gordon's Parent Effectiveness Training.
Mayo Clin Proc, November 1987, Vol 62
The n e x t a n d major section outlines t h e five t e a c h i n g responsibilities of the physician: lectures, group discussions, t e a c h i n g r o u n d s a n d m o r n i n g report, bedside teaching, a n d outpatient teaching. T h i s style undoubtedly reflects t h e aut h o r s ' own careers in the t e a c h i n g of family practice a n d concentrates on h u m a n i s t i c behaviors such a s e m p a t h y , encouragement, advocacy, a n d respectful listening. These characteristics are i n s t a n t l y recognizable a s h a l l m a r k s of successful p a r e n t s , politicians, clergy, m a n a g e r s , a n d all who deal with people—and, a s I t h i n k back on it, are often in short supply in academic centers t h a t m a y prize intellectual t o u g h n e s s more t h a n h u m a n gentleness, scholastic brilliance more t h a n w a r m t h , a n d research productivity more t h a n c o m m u n i c a t i o n skills. I especially recommend t h e section on medical education in the outpatient setting because t h i s occupies a n increasing s h a r e of education a s each year passes. In this setting, t h e a u t h o r s recommend a s a major goal for teacher a n d s t u d e n t to be "capable, sensitive, enthusiastic, a n d g e n u i n e . " T h i s is timely advice for everyone in the field of medicine. E d w a r d G. Lufkin, M.D. Division of Endocrinology/Metabolism a n d I n t e r n a l Medicine
BOOKS RECEIVED Coronary Artery Surgery in the Nineties, edited by Felix Unger, 264 pp, with illus, $80.60, New York, Springer-Verlag, 1987 Handbook of Office & Ambulatory Gynecologic Surgery, edited by Philip D. Darney, 226 pp, with illus, $42.95, Oradell, New Jersey, Medical Economics Books, 1987 Sickle-Cell Anemia and Thalassemia: A Primer for Health C a r e Professionals, by R. G. Huntsman, 219 pp, with illus, $10, P.O. Box 13156, Station A, St. John's, Newfoundland, Canada AlB 4A4, Canadian Sickle Cell Society, 1987 Avery's Drug Treatment: Principles and Practice of Clinical Pharmacology and Therapeutics, 3rd ed, edited by Trevor M. Speight, 1,507 pp, with illus, $60, Baltimore, Williams & Wilkins, 1987
BOOK REVIEWS
1073
The Dynamic Web of Supracortical Consciousness, by Asok Kumar Mukhopadhyay, 167 pp, with illus, $20, Old Mission Road, Bankura, West Bengal, Pin 722101, India, Sri S. K. Mukhopadhyay, 1987 Innovation and Acceleration in Clinical Drug Development, edited by Louis Lasagna and Alexander G. Beam, 170 pp, with illus, $49.50, New York, Raven Press, 1987 Neurotoxins and Their Pharmacological Implications, edited by Peter Jenner, 297 pp, with illus, $45, New York, Raven Press, 1987 Traumatic Brain Edema (Fidia Research Series, Vol 8), edited by F. Cohadon, A. Baethmann, K. G. Go, and J. D. Miller, 186 pp, with illus, $35, Padova, Italy (distributed by Springer-Verlag, New York), 1987 Stroke, by Clark H. Millikan, Fletcher McDowell, and Donald J. Easton, 341 pp, with illus, $48.50, Philadelphia, Lea & Febiger, 1987 Anxious Depression: Assessment and Treatment, edited by Giorgio Racagni and Enrico Smeraldi, 233 pp, with illus, $29.50, New York, Raven Press, 1987 Prenatal Ultrasound: A Color Atlas With Anatomic and Pathologic Correlation, by Beverly A. Spirt, Lawrence P. Gordon, and Michael Oliphant, 148 pp, with illus, $70, New York, Churchill Livingstone (distributed by Longman, White Plains, New York), 1987 Sjögren's Syndrome: Clinical and Immunological Aspects, edited by Norman Talal, Haralampos M. Moutsopoulos, and Stuart S. Kassan, 229 pp, with illus, $100, New York, Springer-Verlag, 1987 Gastritis: A Critical Review, by Rodolfo Cheli, Alessandro Perasso, and Attilio Giacosa, 242 pp, with illus, $79.50, New York, Springer-Verlag, 1987 Clinical Hematology Illustrated: An Integrated Text and Color Atlas, by Victor A. Hoffbrand and John E. Pettit, 248 pp, with illus, $95, Philadelphia, W. B. Saunders Company, 1987 Code Blue: Cardiac Arrest and Resuscitation (Saunders Blue Books series), edited by Mickey S. Eisenberg, Richard O. Cummins, and Mary T. Ho, 244 pp, with illus, $18.95, Philadelphia, W. B. Saunders Company, 1987 Drug Treatment of the Rheumatic Diseases, 3rd ed, edited by F. Dudley Hart, 229 pp, with illus, $48, Baltimore, Williams & Wilkins, 1987 High-Protein Oedemas and the Benzo-Pyrones, by John R. Casley-Smith and Judith R. Casley-Smith, 536 pp, with illus, $49.50, Philadelphia, J. B. Lippincott Company, 1986 Cardiovascular Drug Therapy, edited by Stephen N. Hunyor, 309 pp, with illus, $60, Baltimore, Williams & Wilkins, 1987 Epidemiology in Medicine, by Charles H. Hennekens and Julie E. Buring, 383 pp, with illus, $19.50, Boston, Little, Brown and Company, 1987