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For the next generation of doctors to develop a better bedside manner, it’s important to spend some time in a stable.
Neurosurgeon Dr. Allan Hamilton of the University of Arizona Medical Center, Tucson, is using his ranch for a first-of-its-kind class to help train first year medical students, bringing the humans in close contact with large flighty four-legged patients who can’t talk and who can be highly -- and violently -- reactive to doctors who aren’t attuned to their patients’ body language.
At his first “lecture,” Hamilton shows this year’s class how to safely approach a horse. He slowly walks up to one of his horses, running his hand over the animal’s body as he moves around it.
“I put my arm around him like this so the whole time, even when I go through his blind spot, he knows exactly where I am,” Hamilton tells the students and NBC chief medical editor Dr. Nancy Snyderman.
The slow, careful contact with the animal is not only for self-protection -- the reaction of a startled horse can range from bolting away to spinning and kicking out at something it perceives as a threat -- but also as comfort and reassurance.
The idea for the course began when Hamilton caught himself approaching a patient too abruptly and without the right amount of sensitivity.
“The whole thing started one day when I was in a hurry,” he said. “I was delayed getting to clinic and we just burst into this room because we were in such a hurry and this woman, she just screamed when we walked into the room because we came in so fast. I just remember thinking to myself, ‘boy I never would have done that if that was a horse.’”
The concept makes a lot of sense to Snyderman, a horsewoman herself. “As a physician I hear from medical school professors all the time who say that the students come in eager and passionate about helping others, and leave as cynical and harsh doctors,” she said.
Riley Hoyer, one of the first-year medical students who signed up for Hamilton’s innovative class, recognizes the skills he’s learning.
Right now, “I'm studying books instead of focusing on patient care and so this was just one class that I could do as an elective to try and better learn how to interact with animals and learn how to use my body language to interact with patients,” he told TODAY.
Because horses can’t talk, students need to learn to read their body language to set up a “conversation.” They need to have a rapport and develop trust before the horse will stand still to have its heart monitored with a stethoscope or to get an inoculation.
Snyderman watched as one of the other students connects with a horse. “And now he’s making eye contact with you because you approached him in a very sensitive way,” she said. “It’s a lot like [approaching] a patient.”
Hamilton believes that the program can build better doctors, helping them to overcome fear and improve confidence.
“Probably even more important is it saves doctors,” he said. “Our salvation is going to be to go back to what really makes us fulfilled, which is this essence of human-human interaction and the ability to take somebody in the most dire of circumstances and say,’grab my hand I know we're going OK we're in this together.’”
Hamilton's class has been offered since 2001 and it's gaining attention around the country. Stanford University and University of Medicine and Dentistry of New Jersey are now offering similar courses.
Hamilton didn’t get his horses with a plan to teach students a better bedside manner. “I moved out here specifically to do neurosurgery by day and horses by night,” he said with a chuckle.