Rob Volansky , 2025-04-14 09:30:00
April 14, 2025
5 min read
Health care workers seeking deep meditations and hard-won wisdom on clinical reasoning, mentorship, empathy and learning from mistakes now have a text offering a comprehensive look at the profession.
The book, titled Masterclass in Medicine: Lessons from the Experts, features patient stories and personal reflections from a cross section of health care professionals. It was compiled and edited by Marcy Bolster, MD, professor of medicine in the division of rheumatology, allergy and immunology and director of the Rheumatology Fellowship Training Program at Harvard Medical School; Philip Seo, MD, MHS, associate professor of medicine at Johns Hopkins University School of Medicine; and Jason Liebowitz, MD, assistant professor of medicine in the division of rheumatology and clinical immunology at the Columbia University Vagelos College of Physicians and Surgeons.
“Medicine is intrinsically a very personal and human-centered art and science,” Liebowitz told Healio. “Every doctor hopes to achieve clinical excellence in their practice, but how does one proceed down the path of excellence? Our goal was to create an anthology of essays on this important question from many of the most respected and admired clinicians from across the country and the world. We hoped to create a book containing the collected wisdom of these doctors on key topics such as clinical reasoning, mentorship, empathy, learning from mistakes and other themes relevant to the practice of medicine.”
The editors were careful to include stories of both success and failure, as well as the lessons that could be learned from each. Overall, the hope is to provide a meditation on what it means to be a clinician.
Healio sat down with Liebowitz to discuss the rationale for publishing a book of this kind, the three most important qualities of a health care professional, and why this text is essential for any rheumatologist.
Healio: What was the impetus for this book? What was your ultimate goal?
Liebowitz: Nearly every medical school around the world teaches a class about the clinical foundations of medicine and how to start the process of becoming a skilled and caring physician, but there is no reference text that comprehensively explores this topic in a thorough and engaging manner.
Masterclass in Medicine: Lessons from the Experts brings together talented and renowned physicians from across the globe in order to discuss important topics related to clinical excellence, including humility, empathy and ingenuity in medicine. Students, physicians in training, and health care professionals will gain tremendous knowledge by hearing the stories of what these master clinicians have learned from their patients and colleagues, thereby providing a solid foundation for how to achieve greatness as a clinician.
Healio: Let’s talk about the three key principles you discuss for being a master clinician, starting with humility. Why is humility necessary for being a clinician?
Liebowitz: Humility is a quality that seems to be universally shared by master clinicians not only because of its crucial role in getting the right diagnosis and treatment plan for a patient, but also in allowing for the building of trusting relationships with patients and colleagues.
Even the greatest diagnosticians get the wrong answer at times. It is important for doctors to always keep an open mind and avoid prematurely assuming a position of certainty.
When a physician does make a mistake, or at least needs to call their assumptions into question, it is helpful to maintain a posture of humility and flexibility. Humble doctors are also more likely to appear approachable to patients and other providers. This allows for open dialogue and the construction of strong interpersonal bridges.
Healio: How about empathy?
Liebowitz: In our book, James Kahn, MD, of Stanford Medicine, writes beautifully on this subject. He explains:
“Empathy is a central element in a master clinician’s toolbox, and demonstrating empathy helps to sustain and elevate the clinician-patient relationship. Empathy is used in many clinical and teaching situations, and yet empathy is more than a contrivance applied in clinical situations; it is also a frame of mind.”
Empathy, at its core, is an attunement to the emotions of another person, and Dr. Kahn shares several stories of how the demonstration of empathy has enhanced his ability to care for patients. He also shares the very personal story of his empathic actions in the final moments of his father’s life. This chapter has been recognized by many readers as particularly poignant, and it is clear that the role that empathy plays in medical care is an essential one.
Healio: And ingenuity?
Liebowitz: To demonstrate ingenuity is to be clever, original and inventive. In the practice of medicine, where every generation believes they have all the right answers only to learn later that this is not the case, ingenuity is an indispensable tool that helps the field progress as a whole.
Ingenuity can be demonstrated on the micro level, such as when a clinician is willing to re-examine a patient’s story from a different perspective or consider alternative hypotheses. It can also be employed at the macro level, such as pushing back against conventional wisdom and seeking novel explanations that explain human health and disease.
Healio: Why are these traits particularly important for rheumatologists?
Liebowitz: A great rheumatologist is really a great internist who, in addition to applying the core principles of general medicine, also has specialized knowledge of autoimmune and autoinflammatory conditions. In this role, the rheumatologist is often dealing with diagnostic shades of gray, which requires humility in order to navigate the inherent uncertainty of clinical practice.
Most patients with rheumatologic conditions experience diseases that are chronic, sometimes progressive, and often fundamentally challenging in terms of a patient’s outlook on their own life and abilities. This requires the rheumatologist to be empathic and be attuned to their patients’ emotions.
Finally, the field of rheumatology is young and constantly evolving as we seek to understand the diseases we see at the genetic and molecular level. The discovery story of VEXAS is a prime example of ingenuity in the practice of medicine, and many other such stories are helping to lead our specialty into a bright future.
Healio: It seems you interviewed clinicians across the age and experience spectrum. What did older, more experienced clinicians have to say about humility, empathy and ingenuity? How did it differ from what younger clinicians said?
Liebowitz: What was incredible is that the views of clinicians from across many different ages, genders and specialties aligned incredibly well when it comes to the importance of humility, empathy, and ingenuity. Each of these concepts found its way into most every chapter in the book.
There was an interesting discussion across chapters regarding the effects of age and seniority on these subjects. Experience can allow clinicians the time and space to develop their skills in being humble, empathic and innovative, but it can also sometimes be counterproductive if clinicians allow themselves to stop evolving.
A key point from the book: Never rest on your laurels; always try to keep growing as a doctor regardless of age or experience.
Healio: What other qualities did physicians discuss as critical to being a master clinician?
Liebowitz: Rita Charon, MD, PhD, a literary scholar and the founding chair of the department of medical humanities and ethics at Columbia University, wrote a beautiful chapter entitled “Bach on the Hudson, or the Transformative Creativity of Attention.” The artistry and philosophy of this chapter, which focuses on the importance of paying rapt attention to the patient just as a literary scholar pours over a novel or poem in great detail, is highlighted below:
“Clinicians can’t know in the moment what will be important to the care of that patient. If they could nurture the kind of attention a close reader pays to a text, they might be able to notice and not discard things that patients say about their illnesses that might seem tangential or distracting at the moment but that turn out to be pivotal. Such skills might make the elusive ‘patient-centered care’ more achievable in practice.”
Healio: What overall message would you like to convey to physicians about this book?
Liebowitz: We rarely are afforded the opportunity to experience the collected wisdom of master clinicians as they share their thoughts on topics that touch so many of us as physicians. We believe that this book provides readers with this chance, and we encourage doctors to come back to this text again and again over the course of their careers.
References:
Bolster, M.B., Liebowitz, J., & Seo, P. (Eds.). (2025). Masterclass in Medicine: Lessons from the Experts. CRC Press, Taylor and Francis.