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Med school’s new Rx: Ask ‘what’s right with you?’

What if the first questions out of the doctor’s mouth in the exam room were “What are you grateful for? What do you want your health for? What gives you meaning in life?”

Second-year students in the University of New Mexico School of Medicine are learning how to switch the health care paradigm from deficits to strengths, from diseases to resilience. They are learning to see whole people instead of medicalized patients.

Their Practical Immersion Experience (PIE) places them with medical practices throughout New Mexico, where they are asked to extend this same approach beyond the walls of their clinics, working to gain a better understanding of health from community health leaders.

When we focus on what people and communities do well, these strengths and assets tend to grow into solutions. This positive, empowering approach to healing is often more effective than focusing on the negative. Marginalized and traumatized individuals and communities especially need our systems to focus on building on their strengths, not reminding them of their deficits.

During their PIE rotation, medical students are asked to build “asset maps” with their local mentors in communities that may range from a few hundred people to the larger towns and cities of New Mexico.

In the same way that they learn to map out diseases, addictions and other afflictions, our students now are mapping out the resources, organizations and resiliency factors that each community uses to address specific health issues.

This approach yields real dividends in building greater trust and understanding, as one student in last year’s PIE course reflected.

“It is hard to intentionally focus on assets and strengths when deficits and pathology have been drilled into our heads for so long,” she wrote. “However, in these past few weeks, I am making a concerted effort to take this point of view and really be intentional about getting at patient strengths.”

For me, that sums it up. I’m really excited by colleagues who are looking for ways to turn the conversation around from the very first days of medical school. Instead of teaching students the “What’s wrong with you?” approach, we are getting them to ask, “What’s right with you?

When we ask the right questions, patients, physicians and communities stand to benefit.

Dr. Anthony N. Fleg is director of the Practical Immersion Experience.

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