Why do we say “curiosity killed the cat?”
Isn’t curiosity what drives people to ask insightful questions? To keep an open mind? And to continue learning at age 6 or 60, alike?
Curiosity is what sets apart people who are fixed in their opinions and beliefs and those who adjust in light of new information. Recently, I read an article in The New Yorker that suggested that Donald Trump doesn’t read books unlike most of his predecessors. One aspect of my transition to academia from industry that continues to surprise me (every day!) is how much people read — they not only read peer-reviewed literature in their field, but they also read fiction and non-fiction. They are truly consumers of information!
In their book, Listening to What Matters, the authors suggest that curiosity can drive physicians to ask patients questions — answers to which may turn out to be relevant to the correct diagnosis or the appropriate treatment plan. Curiosity also leads us to listen, rather than speak. So, what does curiosity have to do with patient safety?
Let’s start here. Curiosity is linked to the personality characteristic that is called openness to experience. People that score high on openness are seekers of experience and tend to reflect and think about new ideas they encounter. According to personality models, openness is significantly related to the concepts of intellect and measured intelligence. So people that are curious tend to be smarter or smarter people tend to be curious? Does it matter?
What matters is that curious people actively work to expand their knowledge base whether it’s regarding the current situation in Russia or how your patient’s home life impacts whether or not he can make it to his dialysis appointments.
We tend not to care too much about the personality of our doctors when it comes to the quality and safety of our medical care. Is it because some personality theories suggest that traits are stable over time, while others propose that we can fake it? Can one fake curiosity? Call me biased, but I believe that curiosity is what drives one to become a scientist — after all, science is about asking questions about the world around you and using the answers to create even more questions. It never stops, and that is what we love about it. Believe me, people are not in it for the money. But medicine is not a science. Medicine is the application of generalizable scientific findings to individual cases – in hopes that they stick. It requires a great deal of knowledge, yes, but does the medical field self-select based on curiosity?
If you do a literature search on patient safety and curiosity, you will find that the term curiosity does come up. Medical students are taught to ask questions, not unlike detectives. Lucien Leape stresses that achieving a culture of curiosity, amongst other things, is key to patient safety. Patient harm can be the result of many things including information falling through the cracks — across hand-offs, across care transitions. A great deal of literature suggests that the practice of medicine, aside from the obvious, is also about listening to the patient and asking questions. But more importantly, it’s about asking the right questions. Training and instruction can harness curiosity. For instance, research suggests that experiential learning — learning that involved scenarios and engaging examples, peaks students’ curiosity. One way in which this is relevant is that medical schools and health care systems need to leverage this opportunity.
There are many ways in which our health care system is suffering — lack of open ears of health care providers driven by curiosity is an integral one. For now, as patients, it is within our power and within our role to monitor the safety and quality of our care. Do not be afraid to speak up.
Elizabeth Lerner Papautsky is a psychologist.
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