Progress Notes: One Year in the Future of Medicine

by Abraham M. Nussbaum

A groundbreaking approach to training doctors could transform the future of health care. For decades, physicians have been trained on the textbook of the body, from the corpse in a cadaver lab to the patient in a procedure suite. This type of training usually leads them to specialize in specific organs or systems and breeds an increasingly impersonal view of medicine in which the importance of person-to-person care―the hallmark of a good relationship between doctors and patients―has been lost. In this engrossing narrative, you'll meet seven extraordinary students who embarked on a new way to train doctors that attempts to regain what's been lost. These medical students follow patients instead of physicians, accompanying patients to primary care appointments, emergency room visits, and even surgical procedures, developing deep connections and understanding the intricate interplay between the health of our bodies and the health of our communities. They learn the textbook of a community in addition to the textbook of the body. Through poignant stories of these seven students and the people they meet as patients, Dr. Abraham M. Nussbaum illustrates the power of becoming a doctor and the possibility of changing the way we train doctors. As the students acquire a wealth of knowledge about the human body, they also navigate immense challenges and responsibilities. Throughout the year, they go about their lives, find love, and start families, all while getting to know their patients and their lives. Progress Notes follows the evolution of medical education and is a must-read for premedical students, medical students, and medical professionals seeking insight into the changing landscape of their field as well as for readers captivated by medical dramas and the pursuit of transformative care that benefits us all.

Genres: Medicine

400 pages, Hardcover

Published June 25, 2024

About the author

Abraham M. Nussbaum, M.D., is Director of the Denver Health Adult Inpatient Psychiatry Service, and Assistant Professor in the Department of Psychiatry at the University of Colorado School of Medicine.

Reviews

[Hannah · Rating 5 out of 5]

I will be referring back to this book many times over the next few years. As someone who studied the history of medicine in undergrad, is currently a medical student, and hopes to be a "good physician" in the future (still figuring out what that exactly looks like), I think this book captures so clearly the past and present, including what is good and what is terribly wrong in the profession, and gives a vision of a more perfect future that we can work towards ("We need a system that enchants again and allows physicians to truly flourish, to realize their potential by caring well for patients.")

At the heart of Dr. Nussbaum's book are the journeys of the six students in the Longitudinal Integrated Curriculum, a yearlong experience that teaches them not just how to see patients, but how to follow patients longitudinally and be transformed by the people they care for and form deep relationships with. Medicine is not just, "Come for a season and be the first person in the room when it is time to perform an invasive procedure that you read about in a journal." It should be, "Come for a life and see patients as a fellow community member. Be the first person in the room who knows them." As Dr. Nussbaum writes, "Pursue medicine if you cannot imagine doing anything else. Study medicine because you want to understand someone else's body and community. Train as a doctor to become a physician who cares for the ill so well that they will achieve health they could not achieve without you. And if you pursue medicine, learn from two textbooks"--that of the body, and that of the community.

[Luc · Rating 3 out of 5]

Nussbaum recounts a crucial, crucial redesign in medical school, where a more holistic perspective of patients as individuals and as people embedded in diverse communities is centered from day one. This redesign is essential and deserves wider recognition (and adoption).

At the same time, I left this book unsure whether this is really this author's story to tell and take ownership of. Why was Jennifer Adams, for example, not writing this book as a leader of the program? Why was the emphasis so often skewed toward male "leaders" and figures in the discipline, as well as male bodies and male-relevant medical fields, despite having a GYN specialist as a main character? Why did the author take pains to ensure diverse main characters in race and ethnicity - yet any mention of LGBTQ+ peoples, or lower socioeconomic status peoples, were absent, despite the associated medical center (Denver Health) specializing in treating many such peoples?

[Katelyn · Rating 5 out of 5]

Nussbaum follows a small group of University of Colorado/Denver Health med students in their third year enrolled in Denver Health's LIC (Longitudinal Integrated Clerkship). This program, developed at Harvard, focuses their education on not just medicine, but the community that patients live in as well. Students follow patients throughout the year, regardless of where the patients are treated, to get a bigger picture of their lives. I'm fascinated by medical books about residency, doctors and nurses, and I thoroughly enjoyed this book. Nussbaum looks at how brutal and unhealthy a doctor's education is for students. I was interested in how this program is trying to change the decades-old way that med students learn, for the better.