Writer, Reformer, Physician-in-Training
As an undergraduate volunteering at the Harvard Square Homeless Shelter, Sachin Jain 02 couldnt help but notice that many of its guests struggled with health issues. There was, he thought, a need for a free healthcare clinicso he and a friend, Lewis Shi 00, established one.
Six years later, he hasnt slowed down. Now pursuing an M.D.-M.B.A. at the medical and business schools, he recently coedited a book, The Soul of a Doctor, that chronicles the experiences that transform medical students at Harvard into doctors. The book had its genesis in the all-important third year of medical schoolthe first year in which students are involved in the care of patients, andwhich Jain considers the best year of [his] life. During their time on the wards, all third-years take Patient-Doctor 3, in which they meet in groups to discuss what theyve seen and write reflections on their experiences.
That course had a significant impact on Jain, who quickly realized that his classmates experiences were too important to stay in the classroom. I was really moved, he recalls. A lot of these stories were worth sharing. When he approached the courses longtime director, associate professor of psychiatry Gordon Harper 64, M.D. 69, about the possibility of publishing the essays, he learned that assistant professor of surgery Susan Pories had had the same idea.
The book that Pories, Harper, and Jain eventually coedited shows medical students confronting two difficult realities of medicine: the importance of a good bedside manner, and the complexities of dealing with the healthcare system. This dual focus represents a synthesis of visions: Pories was primarily concerned with students learning to be compassionate doctors, while Jain pursued his longstanding interest in the healthcare system.
|Courtesy of Algonquin Books|
That passion for healthcare reform, meanwhile, also manifested itself in www.ImproveHealthCare.org. He and Kiran Kakarala, M.D. 06, cofounded the website with help from the medical school and financial support from the Commonwealth Fund in response to what they viewed as a need to present the big picture of health policy to fellow medical students. Among the bigger challenges of the endeavor was finding a way to tailor the information to the target audienceto devise a method that would create excitement within the profession for healthcare issues, as he puts it. To this end, Jain and a team of fellow students wrote fictional case studies for the website, on topics ranging from the daunting schedules faced by medical residents to the disparities in quality medical care faced by minorities. (At least 18 medical schools will be using the cases through their own ImproveHealthCare chapters.)
Soul of a Doctor, though, shows Jain and his fellow students confronting such issues in ways that fictional case studies cannot, as they struggle to understand the world they will soon enter. He notes in his introduction that the students offer a uniquely valuable perspective on the current system, because they are educated in medicine, but not yet part of the cultural framework of the medical worldthey can understand the situations they face, yet retain a critical distance. In his own essay, Physicians or Escape Artists? he recalls being instructed by a first-year resident not to follow up a former patient because the man became the responsibility of his primary-care physician as soon he left the hospital. Reflecting on the situation, Jain writes, I felt as if the very values that had drawn me to medicinethe sanctity and transformational power of the relationship between a patient and his caregiverhad been devalued in that single, short conversation.
Reflecting more recently on the incident, Jain speaks with a reformers passion, describing how the increased use of what he terms intensivists and hospitalists results in better healthcare, but at the cost of lost social capital in the patient-doctor relationship. This is, he concedes, an artifact of how medicine is practiced, and he admits that he sees no easy solutionfor now, anyway. Yet he continues to foresee a career in healthcare administration for himself and, despite the connotations of that field, he is quick to note, I take pride in being a compassionate person.