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Randi Hutter Epstein, MD, MPH Headshot

Why Doctors Should Shoot

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Tonight, a dad brought his daughter to my house for a sleepover with my 12-year-old daughter and we starting chatting about this and that. When I mentioned that I write about medicine, he said I should write that doctors need better bedside manner. He had all sorts of horror stories about callous things that happened to him, his wife, his in-laws, etc.

Oddly enough, I had been planning on writing a piece that wasn't exactly about physician etiquette, but it has a lot to do with developing better doctor-patient relationships.

Duke University recently launched a program for residents to learn documentary filmmaking. It's called Documenting Medicine. The point is not to train future movie-makers or photographers, but to provide fledgling doctors with a new lens on their patients. Literally.

Residents choose one project and spend about once a week throughout the school year learning camera skills and discussing their work-in-process.

The hope is that when they hold the camera and talk to the people, they will hear a different story. Not just lab results and medical histories, but about coping with hardships. And in doing so they may be able to develop a deeper level of compassion.

Nearly every medical school these days is trying to teach so-called humanities in medicine -- finding new ways to soften the doctor-patient dialogues. Medical students are visiting art museums, discussing fiction, and writing reflective pieces about their experiences. Photography, though, caught me as something truly unique and perhaps one of the best methods I've heard so far.

Duke's Documenting Medicine program is the brainchild of Dr. John Moses, an associate professor of pediatrics and an instructor at the Center for Documentary Studies as well as Liisa Sinikka Ogburn, a film-maker and director of the program. For Moses -- who studied photography before becoming a doctor -- the camera was a way for him to peer into the lives of those foreign to himself. He realized that taking pictures allowed him to gain a better picture (pun intended) of the people he was treating.

During his residency, for instance, he saw a lot of pregnant teenagers. "I didn't feel very well-equipped to care for them," he told me. So, he started photographing them -- not his patients but reaching out to pregnant teens in other communities. (He needed to maintain the separation of his patients and his film subjects.)

I remember when I was a resident feeling somewhat angry at teens when they became pregnant. They had misbehaved and should have known better. Now I don't feel that way. I'm not saying I'm promoting it. These things happen and my response has changed as a result of the photography. It sounds odd that I can become a different sort of doctor because of my interest in photography, but it's been the case with me.

One of his physician-photography students has focused on newborns in the intensive care unit, another on so-called frequent fliers (people who keep showing up at the emergency room) and another on teen addicts. "I think the most important thing in our program is an opportunity for residents and others to be given time and permission to engage with patients. That is pretty tough these days with all their demands."

Maybe when our new flock of medical students -- many of them immersed in all sorts of humanities programs -- become full-fledged doctors, we will no longer have the curbside conversations about inhumanities in medicine. That will be a relic of the past. For now, check out Documenting Medicine.

As Ogburn added:

From what I've heard from this and last year's residents, it was often patients and stories that first brought these talented young men and women into medicine. This experience allows them to reconnect with that initial motivation at the end of their training, as they head out into patient care on their own.

For those of you, doctors and non-doctors, who have a story to show-and-tell about patients, consider taking a two-day intensives program, Oct 15 and 16th. email Liisa at Liisa.ogburn@duke.edu. And if you go, don't forget to send a comment to me and your photos about your experience. You may find me there as well.

Surgery at the Margins: Understanding Pediatric Trauma from Liisa Ogburn on Vimeo.

For more by Randi Hutter Epstein, M.D., MPH, click here.

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