The Knee Most doctors agree that the dehumanization in the clinical setting can lead to the loss of a patient because of the lack of respect they are given. That is a great incentive for doctors to try to get to know their patients and make them feel as comfortable as possible. When a patient attends a teaching hospital where aspiring doctors exam patients in groups, there is no real reward for them learning personal information about the patient. They will move on to start their own practice and probably never see the patient again.

However, just because the patients are at a teaching hospital does not make them any less important, so how can medical school programs promote patient-physician relationships when the physician has nothing to gain? Morals and ethics would tell a doctor to respect their patient's privacy and keep the examinations discrete. Ideally doctors will know all their patients by name, not disease, know a little bit about their private life and find a point of contact with each patient. When in large groups, doctors and medical students don't really have the opportunity to speak privately with the patients to get to know them, but should they disregard the patient all together and merely address the chief complaint? In Constance Meyd's "The Knee,"all eyes are on the knee; no one meets her eyes" and she is viewed by the students and teacher as "irrelevant" (167). The woman's "embarrassment and helplessness are evident" to the examiners, but they disregard her emotions as they continue the leg maneuvers. Common courtesy would tell the group to close the door and allow the patient to cover herself more adequately, but the author emphasized that the door was open the entire time. It is quite obvious that morals, ethics and common courtesy are not enough to encourage the respect of patients in the educational atmosphere, as is seen in the story.

I believe it is the responsibility of the medical school to encourage their teachers to demonstrate ways to connect with patients rather than just teaching the anatomy of health care. Teachers are supposed to be role models for students and if they are not taught to treat patients with respect, the only way they can learn that kind of skill is the hard way; through the loss of patients because of their feelings of irrelevancy at the doctor's office, or through the complaints of people who are unsatisfied with their quality of health care. It is better to teach them from the start how to work with people. Medical schools wouldn't let doctors learn to diagnose illnesses and conduct operations through trial and error, so they shouldn't allow their students to learn how to conduct patient-physician relationships that way either. How to deal with the emotional needs of patients is not a skill that can be taught easily. For many people it is not something that comes easily.

It is the responsibility of seasoned doctors to provide examples for their students on how to relate to the people they are caring for. Not every skill they use can be imitated by their pupils, but the students would at least have an idea of what kind of things to say to patients and have examples to mimic until they find their own unique way of identifying with the people who go to them for medical help. The attending physician has the moral obligation to provide as much privacy for their patient as is possible when being followed around by a group of medical students. When doctors don't feel this moral obligation, then it is the medical school's responsibility to intervene and provide a way for students to learn and practice communication with patients. They can either find new attending physicians, or they can find another way to encourage medical ethics, it doesn't matter which way they do it, just as long as students are taught the importance of people skills.