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Academia and the Profession |

Music Lessons: What Musicians Can Teach Doctors (and Other Health Professionals)

Frank Davidoff, MD
[+] Article and Author Information

From the Institute for Healthcare Improvement, Cambridge, Massachusetts.


Listen to the author perform Prelude and Fugue Number 9 in E major from Book I of the “Well Tempered Klavier” by Johann Sebastian Bach.

Note: Dr. Davidoff is also Editor Emeritus of Annals of Internal Medicine.

Acknowledgment: Anne Kan, Kathleen Kan, and Molly Cooke contributed important comments on an earlier draft of this paper.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-2470.

Requests for Single Reprints: Frank Davidoff, MD, 143 Garden Street, Wethersfield, CT 06109; e-mail, fdavidoff@cox.net.

Author Contributions: Conception and design: F. Davidoff.

Drafting of the article: F. Davidoff.

Critical revision of the article for important intellectual content: F. Davidoff.

Final approval of the article: F. Davidoff.


Ann Intern Med. 2011;154(6):426-429. doi:10.7326/0003-4819-154-6-201103150-00009
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Medicine is a learned profession, but clinical practice is above all a matter of performance, in the best and deepest sense of the word. Because music is, at its core, a pure distillate of real-time performance, musicians are in an excellent position to teach us about better ways to become and remain expert performers in health care and ways for our teachers and mentors to help us do that. Ten features of the professionalization of musicians offer us lessons on how the clinical practice of medicine might be learned, taught, and performed more effectively.

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Music Lessons: What Musicians Can Teach Doctors
Posted on March 20, 2011
Justine V. Cohen
Pennsylvania Hospital, University of Pennsylvania
Conflict of Interest: None Declared

TO THE EDITOR: I applaud Dr. Davidoff's keen inference that musicians can teach doctors (1). Parallels between music and medicine run deep. Before my medical journey began, I was a professional oboist. Following undergraduate and graduate musical training at esteemed institutions, my summers were spent at music festivals where I had the good fortune to play with some of the world's greatest musicians. Music continues to shape my consciousness as a physician in all of the overlapping aspects Dr. Davidoff astutely identifies. Perhaps the most important 'lesson' for me derives from the impact of practicing music, and what this has taught me about dedication. Arduous hours, days and even years were spent tediously repeating one phrase of a musical excerpt until it was flawless--playing it forwards, backwards, double-time, half-time, and in alternating rhythms on every notch of the metronome, until the last shred of insecurity vanished. As an oboist, when I was not playing the instrument, I was making reeds--the bane of every oboist's existence. Hunched over my desk, gauging, carving, and scraping until the sound produced between two translucently thin pieces of cane was just right; capturing unique color and depth and stability of pitch, optimally adjusted for my embouchure. Playing the oboe demands meticulous awareness and a laser-like focus on detail. These are the same qualities needed in the practice of medicine.

Dr. Davidoff also refers to the conductor as a generalist in music. Expanding upon this idea, internists are the conductors of an orchestra filled with uniquely talented players. The medical record becomes the score determining which specialists are brought together from all fields of medicine, each possessed with skills and knowledge accumulated through years of coaching, practicing and performing. In medicine as in music, group harmony is placed above self-interests; differences between colleagues are resolved in the service of one goal -- healing the patient.

For Dr. Davidoff's vision of musicians inspiring physicians to become better performers in health care and better doctors -- a resounding, bravo! I am only a resident and still have a long way to go but I will carry my 'music lessons' with me for the rest of my career.

References:

1. Davidoff, F. Music Lessons: What Musicians Can Teach Doctors (and Other Health Professionals). Ann Intern Med. 2011;154:426-9. [PMID: 21403078]

Conflict of Interest:

None declared

Music Lessons: What Musicians Can Teach Doctors
Posted on March 30, 2011
Ayodele Odutayo
University of Toronto
Conflict of Interest: None Declared

TO THE EDITOR: The recent publication by Dr. F. Davidoff immediately struck a chord with us and peaked our interest (1). As long-time musicians, we could not help but reflect on how music was already making a difference in our careers as students.

For the past 9 years, we have proudly participated in a local steel pan orchestra. While many may recall steel pan music from a recent Caribbean vacation, playing the steel pan is a very unique musical experience. The performance usually occurs without the direction of a conductor and without the aid of sheet music. This setting therefore adds a new twist to the already challenging task of performing in front of a crowd. Not only must steel pannists remember every musical note for over 25 songs, they must also weave their individual musical contributions into one harmonious melody.

In order to play the steel pan, one must always remember one cardinal rule: 'If you forget the notes, listen to those around you'. In the absence of sheet music and a conductor, this is the only cue that a performer will have to reenter the song. Therefore, teamwork is the essence of steel pan. Performers must trust one another, share control of the tempo (1) and rely on the collective knowledge of the orchestra.

In his article, Dr. Davidoff writes about the benefits of teamwork in medicine (1). However, we wish to particularly emphasize that for current and future medical students, teamwork is likely the most important skill one can have. Even for the most gifted individual, the task of committing an ever expanding list of differential diagnoses to memory is likely unachievable. Similarly, without the assistance of other health care professionals, no medical student or physician can provide comprehensive care to their patients.

Music has been one avenue through which we have personally developed our ability to work collaboratively. With this experience, we are therefore committed to trusting members of our health care team, sharing control of patient management, and providing comprehensive treatment through interprofessional team work.

Reference

1. Davidoff F. Music Lessons: What Musicians Can Teach Doctors (and Other Health Professionals). Ann Intern Med;154(6):426-9.

Conflict of Interest:

None declared

The importance of scales
Posted on April 13, 2011
William E Cayley
University of Wisconsin Department of Family Medicine
Conflict of Interest: None Declared

I would like to add one more aspect of professionalization to the 10 listed by Dr Davidoff. While, as he notes, practice is important for maintaining professional skill, the mundane practice of "playing scales" is vitally important to building professional skill. When teaching students, I commonly point out that to learn to use medical skills artfully and well, you need to practice, practice, and practice some more - just as in music. It takes repetition of scales over and over again to learn the basics of music, and you can't play a the "dogfight" of a Sousa march or the final arpeggio in Light Cavalry Overture without endless repetition. In the same vein, the only way to really learn heart sounds, or what a normal ear looks like, or to palpate a liver, is to practice your physical exam - over and over and over. In both music and medicine, it takes continual repetition of the basics for learners to reach the point where they really "get" it.

Conflict of Interest:

None declared

Musicians who are health professionals
Posted on March 21, 2012
Stephen J, Reid, Lecturer
University of Cape Town
Conflict of Interest: None Declared

Dear Dr Davidoff

Thank you for your article published in the Annals last year entitled "Music Lessons: what musicians can teach doctors (and other health professionals)". In your conclusion or 'Coda' you speculated that "it would be fascinating to ask the many doctors and other health professionals who are also accomplished musical performers to reflect on how music has made a difference in their medical careers". I would like to report that at a recent meeting of the World Doctors Orchestra (see http://www.world-doctors-orchestra.org/ ) in Cape Town, South Africa, a group of 45 people met, consisting of members of the orchestra, faculty and students of the University of Cape Town, and interested others, to do exactly what you suggested.

As musicians and artists who are health professionals, we discussed our experiences of the common ground between the otherwise disparate worlds of arts and health care. In addition to the commonalities outlined in your article, we felt that the major contribution of the arts is as an expression of 'soul', meaning a dimension of experiencing life, ourselves and one another in depth, which is sorely lacking in most health services. Participants shared the experience of being more fulfilled and whole as healers themselves, through an involvement in music or the arts. However, health care and even the expressive and creative arts themselves, are often reduced to a series of techniques rather than touching the deeper and more subjective aspects of humanity that make each of us unique. So your description of medicine as both a science and an art needed to go further, in our opinion, to the implications of including 'soul' in health care. We concluded that there is a great need to practice, teach, research and advocate for the explicit integration of the arts in health care, in order to return to the wholeness that we all need.

We hope that this will be an ongoing conversation.

Prof Steve Reid, Primary Health Care Directorate, Faculty of Health Sciences, University of Cape Town.

Conflict of Interest:

None declared

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