The Power of an Idea

Drs. Arnold and Sandra Gold and a dedicated group of Columbia colleagues, medical educators and community leaders began the Foundation in the fall of 1988 with the power of an idea – to nurture and preserve the tradition of the caring physician.

That idea was conceived in response to a disturbing trend. Burgeoning scientific discoveries and advances in technology seemed to dwarf the interest of taking care of people who were ill, suffering and/or dying. Physician trainees were scientifically proficient and technically well-trained, but often demonstrated a sad lack of caring and compassion. Dr. Gold decided, with Sandra Gold's help and prodding, to do something about it.

The idea to rebalance the dual pillars of medicine and humanism, was formalized in the fall of 1988. The Board spent almost two years researching and discussing the issue, asking questions such as: 

•                  Is it possible to identify candidates for medical schools who are both scientifically proficient and compassionate?
• Are we already selecting idealistic and humanistic young people for medical schools and then, through the medical education process, discouraging their spirit of caring?
• If young doctors are not naturally sensitive, can we train them to be so?

Focus

We concentrated on the values and behaviors that reflect humanism: traits such as empathy, respect, caring, integrity and service. We knew that attitudes might be difficult to change so we focused on changing behaviors. We began our effort at the beginning - working with medical students from their orientation through graduation. We collaborated with medical schools to help shape patient-centered physicians.

Strategies

To spread the habit of humanism,  we devised a set of strategies that included: 

• establishing clear expectations and standards early in the educational process; 
• identifying, rewarding and promoting exemplary role model/mentors;
• providing experiences and opportunities for medical students and residents to understand the patient perspective and to reflect on their role as caregivers. 

Our first significant program effort began in 1991. The “Commencement Awards” were initiated at Columbia University College of Physicians & Surgeons to recognize an exemplary role model faculty member and a graduating medical student. Those initial awards are now named The Leonard Tow Humanism in Medicine Awards and are bestowed at more than 90 of our nation's medical schools.

In 1993, we launched our second transformational program, the White Coat Ceremony, a rite of passage that is now a tradition in medical education.  It is designed to welcome new students into the medical profession and to set clear expectations regarding their primary role as physicians by professing an oath. Today, the White Coat Ceremony, or similar rite of passage, takes place at 94% of the schools of medicine and osteopathy.

Growth and Vision

The question of how else we might influence the culture of medicine was the most difficult to ascertain, and one we continually ask. In 1996, the Gold Foundation convened leading deans and medical educators from throughout the nation to help explore ideas, set priorities and provide us with some concrete suggestions for new programs. We continue to convene the Barriers to Sustaining Humanism in Medicine national symposia, which provide us with concrete ideas, pilot-program partners and an enthusiastic distribution network.

More than two decades after we began, humanism in medicine is no longer an abstract concept but a practical reality. The best barometer of its importance in the medical community is that humanistic skills are now among the competencies required for medical licensure in medical school and residency programs. 

Since our founding, The Gold Foundation has expanded its initial focus from the first four years of medical education to include residency and beyond. Today, we support a broad spectrum of programs and projects to advance our mission to keep the care in healthcare.  

The Foundation's logo, a heart-shaped stethoscope, has already become a familiar sight in medical centers throughout the country and abroad. It is featured on lapel pins worn by over 16,000 new medical students each year. Students and faculty at 93% of our nation's accredited schools of medicine, both allopathic and osteopathic, participate in at least one Foundation program.