Words of truth
==============

* Ivan P. Steiner

*   © 2004 Canadian Medical Association or its licensors

I agree with Dr. Ursus that it sometimes seems difficult to balance the rights of patients to top-notch care and the need to provide a superior education for the next generation of physicians.1 More to the point, however, is the issue of the core philosophy applied in educating our future physicians. Many faculties of medicine have introduced the patient-centred approach as a core educational concept in their undergraduate and postgraduate curricula. In a commentary last year, I described the evolution of emergency medicine teaching and practice in Canada.2 Dr. Ursus now offers me an additional opportunity to weigh in on the need to refocus our attention on the patient as a whole person, in contrast to the viewing of a child as “the broken arm in cubicle 5.” On reading Dr. Ursus's description of his family's experience in the emergency department,1 I was shocked but not surprised that his child was sent for radiography without any analgesia. To learn, teach and serve as a role model for empathy and caring are skills just as important as mastering the arts of diagnosis and treatment. With time, I hope we will see more attending physicians, residents and medical students who understand that the urgent alleviation of suffering is one of our highest duties. My learners know that triaging and starting appropriate resuscitation go hand in hand with making the patient comfortable. This approach, in addition to being humane, provides for a less stressful, and less potentially litigious, encounter for all. It also facilitates better compliance on the part of the patient and the family and improves patients' satisfaction and their perception of the quality of the care received. 

I commend Dr. Ursus for his resolution to treat families more gently. I hope many more will follow his path. 

**Ivan P. Steiner** Department of Family Medicine and Division of Emergency Medicine University of Alberta Edmonton, Alta.

## References

1.  1. CMAJ 2004;170(7):1192.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMDoiMTcwLzcvMTE5MiI7czo0OiJhdG9tIjtzOjI0OiIvY21hai8xNzAvMTAvMTUxNy4zLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

2.  2. Steiner IP. Emergency medicine practice and training in Canada [editorial]. CMAJ 2003; 168 (12): 1549-50. 
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTY4LzEyLzE1NDkiO3M6NDoiYXRvbSI7czoyNDoiL2NtYWovMTcwLzEwLzE1MTcuMy5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=)