A Migraine in Room 3, A Stroke in Room 4

"A Migraine in Room 3, A Stroke in Room 4: A Physician Examines His Profession" endeavors to rekindle the commitment to the human side of medicine by emphasizing patient-centered care. This book is a valuable educational text for medical students and physicians, yet anyone who has been a patient will appreciate and benefit from it. Healthcare in America is in crisis. Rapidly increasing costs, highly variable medical outcomes, widespread dissatisfaction of both patients and doctors, and a reliance on a corporate business model are symptoms of the crisis. This book clarifies the system's failures, while emphasizing the absolute necessity for physicians to treat patients as individual human beings in need, not as medical problems or vessels of disease. Only with a return to this fundamental concept of care can the crisis be appropriately addressed. "A Migraine in Room 3" distinctively addresses the practice of clinical medicine in three interconnected ways. The book begins with a comprehensive analysis of the flaws in today's healthcare system. Second, the clinical skills needed to succeed as a physician are reviewed in detail, accompanied by the author's philosophy of medical education, which has earned him numerous teaching awards. Finally, the reader is treated to a unique treasure trove of patient quotes and vignettes concerning life, family and work, carefully recorded as Dr. Schanfield's patients faced illness, disability, aging and impending death. These often charming, sometimes wise or humorous, and even occasionally irreverent patient remarks could only be heard by a physician who values the principle of individualizing care of human beings. The book concludes with a "top ten" list of steps to be taken to address the failures of the American healthcare system.

"A Migraine in Room 3, A Stroke in Room 4; A Physician Examines His Profession," written by Dr. Paul Schanfield, a clinical neurologist and medical educator, endeavors to rekindle the commitment to the human side of medicine by emphasizing patient-centered care. While the book is poignant and engaging, instructive and informative, it is at times charming and humorous. The book is written for the education of medical students, residents and fellows training to become clinicians. It is a valuable resource for all practicing medical professionals and will be informative and enjoyable to anyone interested in medicine today. Healthcare in America is in crisis. Rapidly increasing costs, highly variable medical outcomes, widespread dissatisfaction of both patients and doctors, and a reliance on a corporate business model are symptoms of the crisis. This book clarifies the system's failures, while emphasizing the necessity for physicians to treat patients as individual human beings in need, not as medical problems or vessels of disease. Only with a return to this fundamental concept of care can the crisis be appropriately addressed. The physician-patient interaction provides medicine with heart and meaning. Perfecting this communication improves the health of the patients, while enhancing both patient and physician experience. The system's primary focus must return to the patients in need rather than on medical problems. A migraine is not in room 3. A stroke is not in room 4. People are in rooms 3 and 4. "A Migraine in Room 3" distinctively addresses the practice of clinical medicine in three interconnected ways. The book begins with a comprehensive analysis of the flaws in today's healthcare system, which is currently preoccupied with the demands of a corporate business and intense insurance/government oversight. The resulting time-intensive emphasis on insurance coverage, documentation demands, and complex coding requirements has eroded the human intimate physician-patient contract as mandated by the Hippocratic Oath. In addition, the book distinctly exposes multiple myths being propagated to alleviate patient unease and physician unhappiness with the system. Second, the book identifies the clinical skills a physician needs to succeed as a clinician, including the acquisition of knowledge, evolution of clinical judgment, and the development of social-emotional mindfulness. This review is followed by an indepth outline of the author's philosophy of medical education, which has earned him numerous teaching awards. Third, the reader is treated to a unique treasure trove of patient quotes and vignettes concerning life, family and work, carefully recorded as Dr. Schanfield's patients faced illness and living with disability, aging, and impending death. The reader is allowed to hear the actual words spoken by people in need as they shared their life stories and health concerns with their physician. Some are laced with wisdom and wit, humor, fear, hopelessness, optimism and strength. While these patient stories add charm and humor to the manuscript, they are a testament to the fundamental importance of individualizing care of human beings in healthcare. "A Migraine in Room 3" concludes with a "top ten" list of steps to be taken to improve our healthcare system by fundamentally returning the primary focus to the patient in need: 1. Treat human beings, not medical problems 2. Emphasize physician social-emotional skills 3. Increase meaningful physician-patient face time 4. Strengthen all forms of healthcare collaboration 5. Decrease healthcare fragmentation 6. Ease the physician burden of record keeping and documentation 7. Ensure judicious utilization of physician extenders 8. Improve general residency training programs to decrease the dependency on sub-specialty care 9. Adjust the number of physicians trained to the needs of the patients 10. Emphasize a whole body, proactive healthcare model

Paul M. Schanfield, MD, a Minnesota Neurologist with a subspecialty certification in Stroke and Vascular Disease, retired after forty years of clinical practice as a perenial Minneapolis/St Paul Magazine "Top Doc"at the end of 2015. As a University of Minnesota Clinical Professor of Neurology, he continues to actively teach medical students and residents in Family Practice and Neurology, and recently lectured at the American Academy of Neurology Annual Meeting on "Mindfulness in the Clinical Practice of Medicine." He has received numerous teaching awards from University affiliated Family Practice residency programs affiliated with the Bethesda Clinic, St. Joseph's Hospital, the Phalen Village Clinic and St. John's Hospital in the east metro area of the Twin Cities. He received the first ever University of Minnesota Neurology Community Educator of the Month in July 2017. In 2018, Dr Schanfield was awarded the Community Teacher of the Year by the United Family Medicine Residency "in the spirit of the great teachers of medicine who have transmitted a heritage of proficiency, scholarship, and caring to us and future generations."