What Musicians Can Teach Doctors, And How Allergists Are Like Rock Stars

"Our Fans Rock", say Cleveland Clinic doctors. Image source: Cleveland Clinic Facebook page.

I went to a concert of the British rock legends Deep Purple last summer. Their biggest hit “Smoke on the Water” was recorded more than 40 years ago. The average age of the musicians is 65 nowadays. I looked around. The audience ranged from the 70-year-old parents of 30-year-old fans to their 5-year-old children. When Deep Purple hit the first big riffs everyone jumped to their feet. The rock stars were clearly in their element - smiling, engaging, and seemingly enjoying the experience, sending great vibes to the audience who sang the songs from start to finish with them. What struck me was that the musicians have played the same song tens of thousands of times by now, and yet it was like their first time. Because it was the first time for their audience.

Smoke On The Water video from "Live At Montreux 2006" DVD:

Allergists are like rockstars too. Read below to see why.

Live performance - every time is like the first time

Allergists educate their patients about asthma and despite going over the same topic for tens of thousands of times, they put the same energy and enthusiasm every time. Because it is the first time for their patient.

Clinic visit is a shared experience, just like a rock concert

A rock concert is a shared experience. Deep Purple could not make the concert without their audience. A clinic visit cannot happen without the patient. Deep Purple's audience ranged from 5 to 75. Allergists see both children and adults, ranging from 90 days to 90 years of age.

A rock hit performed live is a shared experience by both the artist and the audience. The ultimate allergy diagnostic tests - skin testing and spirometry - are shared experiences too. They require both the physician and the patient and provide the immediate satisfaction of quick and accurate results.

The timeless appeal of a rock hit and good medicine

The ultimate rock hymn “Smoke on the Water” is more than 40-year-old and it still works. You should see the sight of 5,000 people singing the same chorus at the top of their lungs. Subcutaneous immunotherapy (SCIT, "allergy shots") is 100-year and still works. In fact, SCIT allows the same patient, gasping for breath last year, to be able to sing at the top of their lungs at a rock concert this year.

Take the magic with you - be it an MP3 file or a teaching website

When you leave the live concert venue, you can download the songs from iTunes and watch the videos on YouTube. The website of your allergist also provides teaching materials for download at home and educational videos to watch on YouTube.

The music of your favorite artist is available 24/7 and on demand. And so is your allergist website, full with educational materials, and working 24/7 and 365 days a year.

At the end of the day, allergists are more like rockstars than one would expect.

Technology in clinical practice

Rockstars moved from acoustic to electric guitars, from vinyl LPs to online streaming. Using technology helps both patients and physicians. An iPad in the clinic helps to explain anatomy and treatment options. A website with educational materials and videos continues the “Cycle of Patient Education” and open the walls of the clinic to world (http://goo.gl/LtvQN). Twitter and Facebook help to share the latest research and create a worldwide community, connecting every allergist to his or her colleagues and patients.

One can listen to MP3s all day long but nothing replaces the experience of a live concert. A social media service such as Twitter just recreates the experience of the now obsolete “physicians’ dining room” where hospital staff used to exchange news about latest research and new developments in medicine. Social media is a natural extension of what physicians do every day - listening and communicating with patients, and trying to make their lives better through collaboration.

Here are the 10 key points from the article "What Musicians Can Teach Doctors" published in the journal Annals of Internal Medicine:

Medical clinical practice is above all a matter of performance, in the best and deepest sense of the word.

10 aspects of the professionalization of musicians offer lessons on how health care practice might be learned, taught, and accomplished more effectively.

1. Performance

Recognition of music's laser-like focus on performance could help us regain a more appropriate balance in medicine between knowledge and performance (between knowing and knowing how).

2. Coaching

Musicians learn to play music by playing it, by moving repeatedly through cycles of experiential learning. But endless performance without feedback drifts into stagnation.

3. Stardom

Few health professionals become international experts because neither health care delivery nor medical education could function if they depended mostly on superstars. The small number of master clinicians who become exceptional teachers apparently do so by learning to step away partially from their performance role.

4. Talent

Most important factors in becoming an accomplished musician are training, practice, and experience, rather than some vaguely defined quality of “talent” or perfect pitch.

5. Time

Achieving a high performance level in any musical style or tradition requires time, and a lot of it - discipline and hours of practice. Medical school and residency involve at least the estimated 7 to 10 years of focused involvement and 10,000 hours of practice. Growing up into an expert takes time.

6. Art

Musical performance can be technically brilliant but cold and mechanical. Masterful performance requires musicians to attain prodigious levels of technical skill, while at the same time going beyond technique into the domain of true musicality. Legendary pianist Vladimir Horowitz is reputed to have said to a woman who told him she loved watching his hands as he played, “Thank you, madam, but what makes you think I play with my hands?”

Medicine is not just science, but a “professional, science-using, inter-level interpretive activity taken for the care of a sick person”; it is, as is often said, both science and art.

7. Practice

Musicians know that performance skill degrades rapidly over time and therefore spend much more time practicing and rehearsing than performing in public. Many professional musicians continue to take lessons for years. There is a common saying among musicians, "If I don't practice for a day, I know it; if I don't practice for two days, the critics know it; if I don't practice for a week, everyone knows it.”

8. Teamwork

Except for keyboard players and folk singers, musicians perform almost exclusively in groups: duos, jazz combos, chamber ensembles, rock groups, or orchestras. And although musicians largely practice alone, rehearsing and playing in groups is a major and essential part of their performance careers.

9. Repertoire

A fundamental element in all of music is bringing the expected together with the unexpected. Developing a basic repertoire of practices and procedures in medicine is important.

10. Specialization

Specialization is the natural order among instrumentalists: oboists often learn to play the English horn but rarely also become violinists.

Stefan Willich, conductor and cardiologist, on similarities between medicine and music. “If you look closely, both are based on a highly structured system. Music is based on mathematics, and medicine has science at its core. But then to make both work, you need to add a lot of subjectivity, a lot of empathy, and a lot of emotion. Music as a mathematical application would be dry, and medicine would not work without applying a good doctor-patient relationship.” Source: The Lancet, 04/2012.

How musicians are different from doctors, or where the analogy does not apply

People go to a concert to be entertained and to have fun. Very few patients go to see their doctor to be entertained. They see them to understand what their medical problem is and to get better. This is one of the fundamental difference when comparing physicians to musicians. In fact, focusing on improving the “consumer experience” in healthcare may have detrimental effects. A recent study showed that higher patient satisfaction was associated with higher health care and prescription drug expenditures, and increased mortality.

Patients see their physicians for the same reason they have been doing it for thousands of year - they want to get better. A doctor needs more than 10,000 hours to perfect the science and art of healing.

Here is how to facilitate the Rise of the ePhysican who works hand in hand with the ePatient:

Products of the Cycle of Patient Education: EQUALS

- Energy!
- Quality of life is improved
- Understanding of patient condition is improved
- "Affinity" - better physician-patient relationship leads to increased referrals to the practice, e.g. 2-5 new patients per week per physician, increased revenue
- Lower rate of ER visits, hospital admissions, phone calls
Savings for patient and health system


Music Lessons: What Musicians Can Teach Doctors (and Other Health Professionals). Frank Davidoff, MD. March 15, 2011, vol. 154 no. 6 426-429.

Social media in medicine: How to be a Twitter rockstar and help your patients and your practice

Rock Star Doctors: What Physicians Can Learn from Musicians « Science Life Blog « University of Chicago Medicine

Doctors are natural communicators - social media is extension of what they do every day

Redefining age 66 - when your job description is "rockstar"

The 10-year rule: you must persevere with learning and practising for 10 years before making breakthrough

BMJ doc2doc blogs - Do musicians have lessons for 'medicians'?

Comments from Twitter:

Nathan Hare M.D. @AllergyTalk: Rock on!

Henry Ehrlich @AACMaven: "Smoke on the Water is an asthma trigger" - @Allergy: not in my experience, but we may need a larger research population.

Henry Ehrlich @AACMaven: Dust in the Wind also a problem.

@DrYesimDem Yesim Y Demirdag: hah cool! I remember you telling me about this idea last month. Now makes sense that one of my patients told me that I rock:)

Dr John Weiner @AllergyNet: Wise words by @Allergy MT @MatthewBowdish Docs Can Learn from Musicians bit.ly/H9ko9B

Linda Pourmassina,MD @LindaP_MD: Rock Star Doctors: What Physicians Can Learn from Musicians - Blog of University of Chicago Medicine goo.gl/SXlA7 {nice}

Rob Mitchum @ScienceLife: Smoke on the Water and 10,000 hours - what can physicians learn from musicians? By @woodtang, ft. @DrVes: bit.ly/H9ko9B

Vijay @scanman: Very good interview, Ves. You Rock Star, you!!

@DrVes: thank you, not a rock star... just a fan... :) http://bit.ly/H40Fbj

June Collmer @CorelliViolin: Thanks. This was great.

No comments:

Post a Comment