Patients??? Perspectives on Physicians??? Roles: Implications for Curricular Reform

PURPOSE: To elucidate the perspectives of patients on the conceptual framework for a new undergraduate medical curriculum organized around the healer and professional roles of the physician (their physicianship), and to illustrate how these perspectives can affect program development. METHOD: In 2006, using an adapted interpretive description design and semistructured interviews, the authors collected data from a sample of 58 patients receiving care in a major academic medical center. RESULTS: Three findings were particularly salient. (1) The concepts of the physician as healer and professional, although central to the curriculum, did not resonate strongly with patients. The words professionalism and healer occasionally accrued negative connotations. There was little concordance between the lexicon patients use to describe ideal physician behaviors and a faculty-defined list of core physicianship attributes. (2) The listening skills of physicians were highly valued and seen as an "essentia" of ideal doctoring. (3) Being treated as a number by physicians represented a threat to patients' personal identity. CONCLUSIONS: This study found important differences between patients' and physicians' perspectives on key curricular concepts. Understanding these differences represents an important resource for program design and development. The findings also suggest avenues for future research on highly topical issues such as professionalism.