NYT: Medicine has a crisis of meaning—but the 'Healer's Art' can overcome it

A course on medicine's non-medical impact could help relieve burnout

Writing in the New York Times this week, David Bornstein explains how the "Healer's Art" medical school course could help bring meaning back to medical professions where burnout and administrative burdens have become commonplace. 

A crisis in medicine

"Medicine is facing a crisis, but it's not just about money; it's about meaning," Bornstein writes.

He notes that burnout in doctors begins as early as medical school, where students face "unrealistic expectations" that keep them "sleep-deprived, overstressed, and in a state of fear of making mistakes." The medical school curriculum claims to teach empathy, while actually encouraging professional detachment and cynicism, he argues.

Once done with training, doctors now find themselves overwhelmed with administrative and documentation burdens. This, Bornstein argues, is not why doctors become doctors.

Moreover, "[t]hese high levels of distress, depression, loss of satisfaction, fatigue, and burnout have big repercussions for quality of care," says Tait Shanafelt, who leads a Mayo Clinic program dedicated to physician wellbeing.

How to overcome the crisis

According to Bornstein, the "Healer's Art" course started at the University of California-San Francisco School of Medicine, where professor Rachel Naomi Remen offered a "subversive addition to the medical curriculum."

The Healer's Art course focuses on the idea that medicine is an ancient calling that draws its strength from compassion, service, reverence for life, and aversion to harm. Student and faculty meet in small groups in the evening to discuss their experiences. The course addresses grief and other critical, non-medical issues that doctors will face over the course of their careers.

Bornstein describes the "Healer's Art" as "an attempt to anchor a cultural shift in medicine" by addressing the effects of medicine beyond basic diagnosis and treatment. Today, the course is taught each year at 71 medical schools, as well as schools in seven other countries (Bornstein, "Opinionator," Times, 9/18).

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