Emily Yoffe was online at Washingtonpost.com on Thursday, July 5, to discuss her adventures as Slate's Human Guinea Pig, the latest of which involved being examined by medical students. An unedited transcript of the chat follows.
New York, N.Y.: Hi Ms. Yoffe,
I just completed my first year of medical school, and thoroughly enjoyed your column. I have had a few experiences with patient-actors, and have found them to be pretty absurd -- both the patient and the student know that this is a patently false and staged experience, yet we have to go through the motions. At the same time, however, I thought it was useful. Do you feel it was a worthwhile experience for the medical students? And did any of your students succumb to the temptation, that I've felt many times, to talk to you out of character?
Emily Yoffe: I hope it was worthwhile for the students! I think this is a great innovation because they get to mess up and be nervous without hurting or infuriating real patients. I did observe some of the other medical students and the standardized patients who were portraying an older person who had fallen, and the SPs seemed very convincing to me. A few of students acknowledged that they knew I was a "fake" but the exam was actually real. One student did ask me where the recording camera was
Washington, D.C.: Do you recommend joining this guinea pig program if you're an aspiring actor? Would this improve one's chances of being an extra on E.R.?
Emily Yoffe: I think it's great for the aspiring actor because after talking to the other standardized patients -- almost all of whom were actors --they said this was some of the best money they earned. Aside what what I learned about medical school, it reinforced my knowledge that the actor's life is hard.
As for ER, I think you have to be on a gurney in LA for that.
Baltimore, Md.: I am am a OB-GYN professor and have ben in the field for more than 25 years. Just for the record, no female physician undresses or performs a pelvic or a breast exam on a female patient without a chaperone. The point of the chaperone is not really to protect the patient. We assume, or hope, at least that medical student and medical professionals are not sexual deviants or predators. The chaperone is there to protect the medical student or professsional from an unwarranted accusation against which there is otherwise no defense.
Emily Yoffe: Fascinating. I never thought of it from the perspective of protecting the doctor!
Anonymous: Hi Emily,
I coordinate the standardized patient program at Midwestern University in Glendale, Arizona. I laughed a lot as I read your article. You sound like you are very good with the students. It takes a special kind of person to work well with student doctors, physician assistants, pharmacologists, podiatrists, dentists....
Emily Yoffe: Thanks so much. It was really fun and it brought up my own memories of stumbling around trying to become a journalist (a stage which some readers believe I've never passed). It was fascinating to see people who end up being god-like acting like baby ducklings.
Washington, D.C.: Did you get any feel for which students, if any, were completely unsuited for the profession, and would be better off in research or leaving medicine altogether? I wonder who tells these kids that. Their instructors, I hope. I was pleased to hear that the professors were watching the exams from outside the room.
Emily Yoffe: I was talking to the other standardized patients and they all say there is a category of medical student they hope only goes into pathology. There were a few who just had star quality, and a few others who seemed so in over their heads. But it's so early in their careers I felt I couldn't make a judgment that any of them should abandon medicine.
New York, N.Y.:"She said they weren't there to diagnose anything."
What does that mean? That if something serious was found nothing would be done?
Emily Yoffe: Yes! I did think: I've just had 23 physicials, and if I find out there is something actually wrong with me, I'm going to be really annoyed.
Nashville, Tenn.: I have my info session/interview on Aug. 7 at Vanderbilt Medical School. Any advice?
Emily Yoffe: If you're talking about advice for being a standardized patient (as opposed to being a med student) yes, if you're a woman shave your legs (I didn't the first day and was so embarrassed every time they checked my knee reflex) and wear nice underwear!
Columbia, Md.: I think that if any doctor had done what Dr. I did, I would have stopped the exam. I do have to wonder what his specialty is going to be and would hazard a guess that he will become a GYN.