Progress Notes: One Year in the Future of Medicine

by Abraham M. Nussbaum

Overview

A groundbreaking approach to training doctors could transform the future of health care.

Winner of the Nautilus Book Award by the Nautilus Book Awards, Winner of the Ippy Book Award

For decades, physicians have been trained on the textbook of the body, from the corpse in a cadaver lab to the patient in a procedure suite. This type of training usually leads them to specialize in specific organs or systems and breeds an increasingly impersonal view of medicine in which the importance of person-to-person care—the hallmark of a good relationship between doctors and patients—has been lost.

In this engrossing narrative, you'll meet seven extraordinary students who embarked on a new way to train doctors that attempts to regain what's been lost. These medical students follow patients instead of physicians, accompanying patients to primary care appointments, emergency room visits, and even surgical procedures, developing deep connections and understanding the intricate interplay between the health of our bodies and the health of our communities. They learn the textbook of a community in addition to the textbook of the body.

Through poignant stories of these seven students and the people they meet as patients, Dr. Abraham M. Nussbaum illustrates the power of becoming a doctor and the possibility of changing the way we train doctors. As the students acquire a wealth of knowledge about the human body, they also navigate immense challenges and responsibilities. Throughout the year, they go about their lives, find love, and start families, all while getting to know their patients and their lives. Progress Notes follows the evolution of medical education and is a must-read for premedical students, medical students, and medical professionals seeking insight into the changing landscape of their field as well as for readers captivated by medical dramas and the pursuit of transformative care that benefits us all.

Product Details

ISBN-13:	9781421448947
Publisher:	Johns Hopkins University Press
Publication date:	06/25/2024
Pages:	408
Product dimensions:	6.00(w) x 9.00(h) x 1.20(d)

About the Author

Abraham M. Nussbaum, MD, is the Chief Education Officer at Denver Health and a professor of psychiatry at the University of Colorado School of Medicine. He is the author of The Finest Traditions of My Calling: One Physician's Search for the Renewal of Medicine.

Table of Contents

Prologue: See One
1. Dead Its
2. Punisher Time
3. Chased Dreams
4. Bliss v. Stone
5. Dark Forests
6. Laying Favorites
7. Instructional Chalice
8. Language Games
9. Day-Tight Compartments
10. Coffee Shop Revolution
11. Downward Arrow
12. Hang-Ups
13. Manifested Checklists
14. Killing Your Number
15. Century Women
16. Grave Disease
17. Insignificant Others
18. Forgetting Curve
19. Falls Risk
20. Confidence Intervals
21. Daily Works
22. Giveaways
23. Natural Attorneys
24. Gratitude Exercises
25. Essential Workers
26. Pandemic Declarations
Epilogue: Esperanza
Acknowledgments
References
Index

What People are Saying About This

From the Publisher

With prose like poetry, physician-author Dr. Abraham Nussbaum writes with emotion without losing sight of reason. He knows that medicine is broken and that medical education is outmoded—and he offers a vision for how things might be different, a vision that is as hopeful as it is realistic.
—Nathan Carlin, McGovern Medical School

Through powerful storytelling, Dr. Nussbaum gives us the drama and heartbreak of medical students seeing patients for the first time, but he also gives us hope. Progress Notes is a hopeful story of students and physicians imagining what health care could be for us all.
—Keisha Ray, author of Black Health: The Social, Political, and Cultural Determinants of Black People's Health

Progress Notes is critical reading for anyone interested in understanding, practicing, teaching, or reforming medicine—which should include all of us. At once aspirational and inspirational, Dr. Nussbaum reveals a better way to care for patients and train young doctors, imparting hope for the future of medicine.
—Lydia Dugdale, Columbia University, author of The Lost Art of Dying: Reviving Forgotten Wisdom

What if students learned medicine not from instructors but by experiencing health care alongside their patients? In Progress Notes, Dr. Abraham Nussbaum deftly chronicles a whole new paradigm for medical learning that goes beyond inverting the classroom and shows us the very roots of our beautiful yet troubled profession.
—Ricardo Nuila, Baylor College of Medicine, author of The People's Hospital: Hope and Peril in American Medicine

In Progress Notes, Abraham Nussbaum has written a stimulating and thoughtful account of the longitudinal integrated clerkship, a new model for teaching medical students how to become doctors without losing their compassion and humanity. Contextualizing the students' experiences with medical history, he argues the hopeful case that it is the patient who makes the doctor.
—Victoria Sweet, author of God's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine and Slow Medicine: The Way to Healing

Out of the dark abyss of modern American medicine comes this message in a bottle, filled with optimism and hope. Progress Notes is a wise, elegant reminder of what makes the practice of medicine worthwhile.
—Carl Elliott, University of Minnesota

Editorial Reviews

An ingenious new approach to educating doctors.
—Kirkus Reviews

An excellent compilation of narratives about longitudinal medical education and its value.
—Matthew Loftus, MD (AIC Litein Hospital-Kenya), 2024, © Doody's Review Service

From the Publisher

2024-04-17
An exploration of “how physicians can see patients better.”

Nussbaum, chief education officer at Denver Health and author of The Finest Traditions of My Calling, agrees that the 19th-century introduction of science into medical education was an admirable revolution that converted medicine to a profession based on human physiology rather than folk beliefs. The result has been miraculous advances in curing diseases and repairing broken bodies, but people still get sick and die. Indeed, they often stay sick longer, take longer to die, and have limited access to appropriate cures. Nussbaum maintains that medical education, now based on the “textbook of the body,” should expand to include the “textbook of the community.” He makes his case by describing a pilot program at the University of Colorado, where he is a professor of psychiatry, and similar programs are being instituted at a few other schools. Medical students traditionally spend their third year in a hospital rotating through the specialties (surgery, obstetrics, psychiatry, etc.). The author describes seven students who do not follow doctors but patients, accompanying them to clinics, emergency rooms, and surgical procedures, as well as to their homes and communities. This approach, as Nussbaum demonstrates, has proven transformative, especially because research shows that “social determinants have more effect on a patient’s health than a physician’s clinical care.” The author also describes how, in the past few decades, medical schools have started paying greater attention to communication skills, and classes now include far more women and people of color. Nussbaum lays out his concepts with refreshing clarity, though he notes that his vision of medical education remains a work in progress. Given the success of the pilot programs so far, readers will hope that the work continues to improve and spread to more medical schools and hospitals.

An ingenious new approach to educating doctors.

Kirkus Reviews