In many professions, “difference of opinion” is code for “all out conflict” or “war.” When you “agree to disagree,” you are often agreeing to part ways. This is the case in the political arena, where campaigns, interest groups, and even research organizations are often partisan, and even in the corporate world, where Boards of Directors and executives are chosen because of a shared vision of leadership. In our medical school class, we often agree to disagree, and our differences of opinion lead to thought-provoking and lively conversations. The differences of opinion I have with my classmates will make me a better physician.
A few weeks ago, we discussed motivation interviewing in our clinical medicine class. As a classmate and I walked out of Richard Jones Hall, I expressed an opinion on the lecture, and was surprised that he passionately and coherently expressed a different point of view. Should doctors confront their patients about harmful behaviors? What are the risks of doing so, and what should the practical and ethical considerations be? As we talked, several classmates joined us. Some contributed their perspectives, and many just listened. After a recent exam, a few of us discussed the best ways for scholarship monies to be divided amongst medical students. Should financial aid be merit based, need based, both, or neither? What other factors should be considered? Not only were we able to agree to disagree over this potentially contentious issue, the conversation continued within our class and with the administration. In fact, the administration has joined our conversation several times, when members of our class expressed strong opinions about our curriculum and its evolution. What say should we have in the changes to our curriculum? How accountable is the administration to its students?
Last week at a student-run clinic, a resident and I visited a patient together. Her case seemed straightforward and our encounter was brief. Later, I asked the resident a few follow up questions about the patient’s care. I worried I might sound silly, but I had a few lingering concerns. The resident carefully explained the case to me, and during our conversation, we realized that we might have missed something important. We reviewed her chart, discussed it with the attending physician, and ordered more labs and a comprehensive follow up. Had I not been empowered to voice my concerns, or had the resident not welcomed an open conversation, the patient may not have received the best quality care. When my classmates and I vehemently disagree one moment, then joke around or bemoan our workload, we practice skills of openness, humility, and professional discourse that will lead to better clinical outcomes.
If people glance at photographs of our class, they could easily conclude that we are not very “diverse.” In many ways, they would be right. This paucity of diversity was a real concern for me when I decided to join this community, and it still is as a community member. However, I must say that I am pleasantly surprised by the diversity of background, opinion, belief, and knowledge bases represented in my class, and more importantly, by the courage and eloquence my peers demonstrate by expressing their opinions vocally and articulately. We put pressure on our administration, on our teachers, and on each other. I think that this will make us better doctors and better people, and I am proud to be part of a community that encourages disagreement and discourse.