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A Hands-On Approach

A Hands-On ApproachThechairman of the neurology department at Tufts’ School ofMedicine is one of the last remaining doctors who adhere to thetime-honored practice of patient-centered grand rounds.Boston

Boston [01.19.05] In an era of privacy concerns and physicians with busyschedules, some think the quality of patient interaction may beon the decline. But Tufts’ Dr. Allan Ropper is hoping toturn that trend around. One of the few physicians in the areato use the time-honored tradition of examining and talking withpatients in the presence of fellow doctors and medical students,Ropper is helping a new generation of doctors learn the art oflistening to patients.

"In neurologyyou have to have hands-on face time," Ropper, chairman ofTufts’ neurology departmentand the chief neurologist at Caritas St. Elizabeth’s MedicalCenter, told The Boston Globe.

The practice,called grand rounds, was once a standard teaching method thathas fallen by the wayside with the advent of a more lecture andtest-based approach to medical education – as well as increasedattention to patient privacy.

"Medicinebecame more academic, less craft," Ropper, who gained experiencein the process during his residency at Massachusetts General Hospital,said to the Globe.

For Ropper,the process is not only valuable in consulting with fellow medicalprofessionals and teaching aspiring doctors, but also in honinginteractions with patients.. Medical educators note that oftenpatients feel honored to be part of the medical training process.

“Illnessesare complicated. People are complicated,” Ropper explained.“You can do all the laboratory tests, but you need to solvethe problem in the human condition.”

The Globeshadowed Ropper on grand rounds with a woman who recently suffereda seizure and had experienced symptoms including dementia andthe inability to walk.

Ropper, theGlobe recounted, queried the patient about her conditionand subjected her to a series of tests while a large group ofdoctors, residents and students – including personnel atTufts-New England MedicalCenter and Carney Hospital connected via a video link –looked on.

Ultimately,Ropper reached a preliminary diagnosis that the patient was sufferingfrom the rare auto-immune disorder Rasmussen's encephalitis.

While Ropper’slist of clients has ranged from everyday people to celebritieslike Michael J. Fox and OzzyOsbourne, the Tufts doctor approaches each case with the samedue diligence – a major part of which, he believes, is theold school of teaching to which he subscribes.

"Grandrounds recognize that medicine is a craft,” Ropper toldthe Globe. “I view it as a way back to the future."






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