To the Editor:

I really enjoyed “Building a New Health Care System” [Editor’s Page, January 2002, page 12]. It resonated with my own thoughts on medical school curriculum changes that I see as inevitable as we prepare our future physicians.

We will have to expand our current focus from acquisition of knowledge (i.e., cramming young minds full of medical facts and principles) and broaden our curriculum to include concepts of systems thinking, communication and teamwork.

The old concept of “captain of the ship” no longer always applies in our current milieu of complex, integrated, multispecialty medical care. Rarely is one person ever totally in charge. Nurses, pharmacists, consultants, laboratory and radiology technicians, as well as clerical personnel are involved in most patient care. In fact, the concept of single control and supreme command stands in the way of effectively resolving or improving medical outcomes, if we persist with a “blame and shame the responsible party” mentality. Instead we must begin to teach our medical students a culture of safety, teamwork, patient empowerment and involvement, as well as systems thinking if we are to truly build a new system of care.