A message from the dean

The month of August included some disappointing news. As you’ve probably heard, Nebraska Medicine conducted an extensive investigation in June and July following reports of harassment, retaliation and other inappropriate behavior within certain units. Unfortunately, the investigation substantiated some of the allegations, which in turn resulted in corrective actions. 
 
A letter communicating the investigation results was sent from myself and Dr. Jim Linder, CEO of Nebraska Medicine, and was distributed widely across UNMC/Nebraska Medicine. In addition, we had a thorough and open discussion with leaders, which included managers, directors, executives and physician leaders from both.
 
At UNMC/Nebraska Medicine, we have a strong commitment to our core ITEACH values – innovation, teamwork, excellence, accountability, courage and healing.  As was stressed in our letter and at our meeting with leadership, there is absolutely no tolerance for harassment or retaliation in our organization.
 
While the above findings were extremely disappointing, it is important to note that most of this unprofessional behavior was limited to a few individuals and locations. Of the broad group of people interviewed as part of the investigation, the overall work environment at UNMC/Nebraska Medicine was viewed quite favorably and there was a great deal of pride related to being part of the organizations and its mission.
 
As I was reflecting upon what needs to be different moving forward, I also was preparing my comments to the Class of 2023 for the annual White Coat Ceremony on Aug. 23. It struck me that one of the challenges that we all face is that at times it is easy to forget about why we chose careers in medicine and drift into behaviors that do not fit the ideals that attracted us to this profession.
 
In that vein, I thought it might be appropriate to share my comments to this year’s entering class with you:
 
"The White Coat Ceremony is the first step in the transition of our newest class of students in the UNMC College of Medicine to becoming physicians. The white coat symbolizes the privilege that medical professionals are granted to participate in a unique and very personal way in the lives of their patients. It embodies the highest principles of respect, competency, service and integrity, and it should not be donned casually.
 
"The white coat ceremony was introduced into U.S. medical schools in the early 1990s, and a majority of America’s medical schools now have some version of the ceremony. It marks the beginning of what will be a long and challenging journey for each of you. Over the weeks and months ahead, you will spend countless hours learning how to conduct a medical history and physical exam and use that information to generate a diagnostic and treatment plan.
 
"The amount of information you will be asked to master will be overwhelming at times and you will almost certainly find yourself sacrificing participation in social and family events, as well as sleep at times, in order to accomplish this.
 
"However, medical and scientific knowledge alone do not make one a complete physician. In addition to being a science, medicine also is an art. The art is embodied in the relationships that you establish with patients. Each patient is unique and reflects not only their genetic makeup but the different environments in which they have lived and currently live.
 
"We are part of a tremendously diverse and global society, and you will encounter patients from a wide variety of cultural, geographic, social, and economic backgrounds that will impact their health and your ability to care for them. Understanding the influences of these factors also is part of being a physician and wearing the white coat.
 
"Although much of what we will teach you will focus on such things as the best combinations of drugs, surgery and other treatments for a specific disease, there will be times that you will not have anything medically to offer your patient that will cure or significantly modify the course of their disease. Surprisingly, it may be those times that you will be of the most benefit to your patient – and in turn – have your most rewarding experiences as a physician.
 
"Faced with patients with essentially untreatable fatal disease, you may have little to offer but your emotional support and compassion. Yet, that is often what is most needed and is just as much a part of being a physician as is meeting their medical needs. This also is what it means to wear the white coat. Don’t shy away from it. It can be the most satisfying part of your career.
 
"In closing, I would welcome each of you into the fellowship that is the practice of medicine. It is a wonderful and fulfilling career. There is much controversy going on around us about the economics and politics of health care. However, the true profession of medicine and the professionalism, as symbolized by the white coat, is about the sanctity of the individual physician-patient relationship. Patients will be placing their lives in your hands and you must honor their trust.
 
"Shortly, you will be putting on your white coats for the first time. As part of a longstanding tradition at UNMC, you will sign your name into a book that starts your journey.  You will sign the book for a second time as you leave UNMC with your M.D. degree.  However, even then your development as a physician will only be early in its course. Being a physician is a lifelong process of education and growth that you will do in partnership with your patients and your peers. It is our honor to be with you today as you embark on this wonderful journey."
 
In closing, I would encourage us all to rededicate ourselves to the ideals of what it means to be a medical professional and the ITEACH values that should define the culture of UNMC and Nebraska Medicine.