By Matt Wood
In his 2008 book “Outliers,” Malcolm Gladwell wrote about the “10,000-hour rule” to explain what sets extraordinarily successful musicians, athletes and business leaders apart from the rest of us. Being talented helps, but Gladwell said that an aspiring artist or entrepreneur also must put in an enormous amount of time honing their craft to become truly great.
Gladwell cited studies by psychologists and neurologists that put the magic number of hours of practice needed at 10,000. The Beatles, for instance, made their big breakthrough after spending part of two years in Hamburg, Germany, playing at nightclubs up to eight hours a day, seven nights a week. Of course, there was more to John, Paul, George and Ringo than sheer mastery of the guitar and drums. Successful musicians know how to connect with their audience and create a lasting experience more satisfying than listening to a song on the radio.
Can this same mix of talent, skill and charisma also apply to the practice of medicine?
Ves Dimov, MD, assistant professor, allergist and immunologist at the University of Chicago Medicine, thinks so. “There are quite a lot of similarities between performing musicians and doctors.” he says. “The audience — your patient — takes part. You have to engage them and provide answers to their questions, a correct diagnosis and treatment that works.”
Dimov recently wrote a blog post about the similarities between performing music and practicing medicine. He recalled a Deep Purple concert last year in which the band played their biggest hit, “Smoke on the Water,” recorded nearly 40 years ago. “What struck me was that the musicians have played the same song for tens of thousands of times by now, and yet it was like their first time. Because it was the first time for their audience,” he wrote.
The blog post was in response to an article from the Annals of Internal Medicine, “Music Lessons: What Musicians Can Teach Doctors (and Other Health Professionals),” by Frank Davidoff from the Institute for Healthcare Improvement. Davidoff outlined aspects of professional music that offer lessons on how health care providers can learn and practice more effectively. “Understanding how professional musicians are trained may help us think more clearly about better ways for physicians, as well as many other health professionals, to become and remain expert practitioners,” he wrote.
Dimov said that this comparison works especially well when thinking about the parallel between musical practice and medical school. “You need a few years of practice before you’re comfortable enough to create this empathy with patients and achieve accuracy in diagnosis and treatment” he said. “You can’t just take the knowledge from books and go see patients right away.”
Gladwell’s 10,000-hour rule comes into play again here, as students struggle through their first few years of medical school. “Talent is essential, but you get better as you practice more,” Dimov said. “After the third year of medical school you start to see things a different way. When you’ve seen a certain number of patients, you’re able to synthesize that knowledge and come up with a treatment that works. If you don’t spend the time, you just don’t reach this stage.”
Once a physician reaches that stage, practicing medicine becomes a matter of performance, using the knowledge and skills earned from years of hard work and applying it to patient needs. “Allergists educate their patients about asthma, and despite going over the same topic for tens of thousands of times, they put in the same energy and enthusiasm every time,” Dimov wrote on his blog. “Because it is the first time for their patient.”
The analogy between music and medicine doesn’t always work though. Musicians are entertainers first and foremost, and while doctors do their best to engage with their patients and make them feel comfortable, they’re focused on helping them get better. “Patients want to be comfortable during the clinic visit, but most importantly, they want to get better,” Dimov said in an interview. “They like to have a good time at their physician’s office, but it’s not at the top of their list. This is a big difference between musicians and seeing patients.”
But that connection with the patient, listening to their problems and adjusting their care appropriately, isn’t much different from the way a band listens to its audience and responds by adjusting its set list or playing just the right encore. That kind of empathy comes only from working directly with patients-or an audience-for years.
“It’s interesting, if you ask medical students in the their fourth year who their most memorable teacher was during medical school, most likely they’ll remember someone who taught them something at the bedside in clinic,” Dimov said. “This is how we help patients the best.”
Davidoff F (2011). Music lessons: what musicians can teach doctors (and other health professionals). Annals of internal medicine, 154 (6), 426-9 PMID: 21403078