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Both were avoidable errors, and Dr.Denton saw them as demonstrating alack of sensitivity and respect. She believesthey show medical professionalsat something less than their best.The lack of communication inthese two incidents is also a symptomof what could be a larger problem withmore serious ramifications. A culture ofpoor communication breeds mistakes.“Communication is critical inany area, whether it’s doctor-patient,doctor-to-doctor, doctor-to-socialservices or other administrative peoplewithin the hospital,” Dr. Denton said.“If you have a lack of communication,things can go awry real quick.”The medical mistakes Blake Heinz,D.O. (COM ’12), M.A. (COB ’12), haswitnessed have primarily dealt withphysicians not doing their homework. They failed to checka patient’s medical history or gather enough informationduring the initial encounter.Dr. Heinz recalls a woman in her 50s who was dyingfrom cancer and, because of acute problems, was admittedto the hospital.“The push these days is to get an advance directive duringthe first interview,” Dr. Heinz said. “Without it, patientsmight not have their wishes met.”In this case, there was no advance directive. Because ofher condition, the woman could not speak for herself. Sheunderwent surgery and recovered – from the immediateproblem, but not from the cancer that was killing her. Onlyafter the costly and painful procedure did the hospital stafflearn that the woman had not wanted any kind of intervention.Again, a lack of communication created an expensiveand traumatizing mistake. To avoid such errors, Dr. Dentonsaid, “You have to know you’ve done everything you can forsomebody.”And, a large portion of everything is communication.Training Physicians to CommunicateThe sensitivity to communication issues that Dr. Dentonand Dr. Heinz reveal in their anecdotes seem to say a lotabout them and also about their education. In a way, osteopathicmedical schools like KCUMB have a head start whenit comes to teaching students to communicate well and tobe able to form close bonds with their patients. Empathyand communication skills are prominent among the qualitiesfound in students who win admission to the University.“Even the smartest students from Ivy League schoolsand with a 32 on their MCATs might not make good osteopathicphysicians,” Dr. Parrott said. “KCUMB looks forpeople who can communicate. We look for empathetic,KCUMB's osteopathic medical students practice their doctor-patientcommunication skills by interacting with mock patients inside theKesselheim Center for Clinical Competence.socially adept people. There’s a lot of focus on listening skills.”Just appearing empathetic is not enough, however.Osteopathic medical students at KCUMB have to build ontheir skills throughout their training.Dr. Moller points to a pilot project in the bioethics programthat pairs students with “patients” who present withsensitive issues, such as end-of-life concerns or domesticviolence. Students learn how to communicate informationabout resources and to help the mock patient feel safe,combining knowledge with compassion during a difficultconversation with a vulnerable person.Before KCUMB’s osteopathic medical students can goon clerkships, they must pass a sort of “communicationtest.” They see three mock patients – volunteers and actorsfrom the community – who present with various health problems.The students must demonstrate both their knowledgeand their communication skills as they seek a diagnosis.Dr. Heinz found the exercise both challenging andsatisfying.“I treated them as though they were real-life patients,”he said. “You have to if you’re going to get anything out of itand pass the test.”In all probability, there will be many more tests forDr. Heinz and Dr. Denton as they progress in their youngcareers. They will make mistakes and be forced to deal withmedical errors made by others. For now, they have confidencenot only to take on the inherent responsibilities thatcome with being physicians, but also to work toward thecontinuous improvement that will reduce medical mistakesand their consequences.campusnewsOsteopathic Medical Students Participatein KCUMB’s First International ClerkshipsThe circuitous route that tookCornelius Thiels and Paul Rotert, D.O.(COM ’12), to Saudi Arabia and Zambia,respectively, included Springdale,Ark., and the Dominican Republic. Italso involved the Kansas City Royalsbaseball team.Dr. Rotert, who graduated May19, and Thiels, a fourth-year osteopathicmedical student, are the firstof what promises to be many studentswho will take advantage of KCUMB’snew international clerkship offerings.Supervised by INMED (the Institute forInternational Medicine), the electiveclerkships are designed to broadenstudents’ perspectives on the practiceof medicine in developing countries.KCUMB has been active in internationalmedicine for 20 years, first inGuatemala and then in the DominicanRepublic, said John Dougherty, D.O.(COM ’92), associate dean for clinicaleducation and medical affairs, andprofessor and chair of family medicine.However, the school’s association withINMED has allowed it to expand itsoutreach to many more countries.It all sounds straightforwardenough now, but the program’s beginningswere a case study in serendipity.Dr. Dougherty was the physicianfor the Royals’ AA team in Springdale,Ark. Many of the players hoping tomake their way into the major leaguesare from the Caribbean nations andSouth America. Their first stop is theRoyals Baseball Academy in the DominicanRepublic.Not long ago, one of these playersmade it to Springdale, but his sportscareer was derailed by a health issue.Dr. Dougherty suggestedthat players bechecked for physicalproblems before beingsent on to Springdale.The Royals thoughtthat was a good idea.The young man whowanted to play professionalbaseball butfound himself stymiedby illness was still onDr. Dougherty’s mindwhen Darin Haug,D.O. (COM ’01), executivevice president foracademic and medicalRecent KCUMB graduatePaul Rotert, D.O., checkson a young patient in aclinic in Zambia.Cornelius Thiels chose to participate in one ofKCUMB's international clerkship offerings inSaudi Arabia.affairs, and dean of the College of OsteopathicMedicine, asked him to takecharge of developing a comprehensiveinternational clerkship program.Here was a chance to take healthcare where it was needed. At the sametime, it was an opportunity to giveKCUMB’s osteopathic medical studentsan educational experience thatwould expand their horizons.Rotert returned from Zambia onMay 2, after two months working in asmall hospital and outpatient clinic.“The most important thing wasprobably the realization of the dignityof all humans and that one’s place ofbirth, position in society or wealthshould not affect the quality of carethat they get,” he said.Thiels left for Saudi Arabia a fewdays before Rotert returned. He recognizedthat Saudi culture tends to bevery conservative, but felt comfortable.“I think all physicians must bemindful of other cultures, and I hopethat experiencing the culture and traditionsin Saudi Arabia firsthand willmake me a better physician one day,”Thiels said.Dr. Dougherty hopes to use thenew international clerkship offeringsto attract more students to KCUMB.“We want to attract the best andthe brightest students we can,” he said.“Sometimes, even just the potential forthe opportunity is what will make themselect or de-select a school. If you don’thave it, the people who do are going toget the brighter students.”18 Summer 2012 KCUMB CommunicatorSummer 2012 KCUMB Communicator 19