Doctor: Hidden medical school agenda' puts efficiency over patients. UPI/Mike Theiler

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NEW YORK, June 28 (UPI) -- A U.S. doctor says a "hidden medical school curriculum" teaches hierarchies, values efficiency over patients and cultivates a doctor-patient communication sham.

Dr. Danielle Ofri, who has practiced medicine at New York City's Bellevue Hospital for the last two decades is the author of the "What Doctors Feel: How Emotions Affect the Practice of Medicine." She says the medical world offers daily challenges to doctors' empathy.

Ofri said medical students lose empathy in their clinical years as they try to deliver medical care in a world of increasing paperwork and sleep deprivation, and it often sends doctors into the field jaded and embittered.

However, compassion can be hard to summon, when patients are hostile or manipulative, entitled or arrogant or have illnesses that appear to be self-induced, such as drug and alcohol addictions or morbid obesity, Ofri said.

Culture, class and language barriers, can also work against doctors staying in touch with their patients' suffering. Asian patients tend to keep up a stoic front, Ofri noted, meaning doctors stop "seeing" their pain, while Hispanic patients are known for being very vocal about their symptoms, so doctors might quickly stop listening.

There has been a steady stream of research into how doctors think -- disillusionment with the realities of being a doctor, frustration because some patients cannot be helped or resentment toward those who will not help themselves, Ofri said. Yet little attention has been focused on how they process emotions -- and how those emotions affect the quality of medical care they provide, the doctor said

"Doctors who are angry, nervous, jealous, burned out, terrified or ashamed can usually still treat bronchitis or ankle sprains competently," Ofri said in a statement.

"Problems arise when clinical situations are convoluted, unyielding, or overlaid with unexpected complications, medical errors, or psychological components. This is where factors other than clinical competency come into play."

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Physician reveals the 'hidden agenda' of medical school