Rounds to Residency

Nephrology Rotations and Free Market Medical Care with Kenneth Fisher MD

Dr. Kenneth Fisher discusses patient care in a hospital setting, hope for the future of the medical system, and the complexity of contemporary medicine.

Dr. Kenneth Fisher practiced as a nephrologist for 31 years, is the author of multiple books related to healthcare including most recently Understanding Healthcare: A Historical Perspective, and is Co-Founder Michigan Free Market Medical Association. Kenneth believes in a medical system without the middleman and with greater price transparency. Medical expenses would be paid by cash and healthcare accounts as opposed to medical insurance.

In clinical education for nephrology, the main focus is on patient care in a hospital setting. This can be through private practice or as a hospital employee. A preceptor interested in this specialty should be concerned with the quality of their ability and desire to teach the medical student. Understanding the thinking patterns of the student’s thought process is a key skill to develop. A preceptor must also be careful in double-checking all student work and assessments. Pharmacology and pathophysiology of kidney disease is a complicated mesh and overlooked data can lead to disaster.

Preceptors teaching in contemporary medical education need to make the learning environment conducive to deep thought. Inspiring students to come up with great questions is both beneficial to the student and more engaging for the preceptor. Electronic health records are a great impediment to the time allotted for student education. Encouraging more discussion about the student thinking process can build the knowledge base for the student and alert the preceptor into knowledge gaps.

Students learning in contemporary clinical medicine need to be aware of the complexities of modern medicine. With the system as is, time constraints that may be involved, and dedicated time needed for data entry, students may have less time to learn. For nephrology, it is important to have a firm grasp of pathophysiology. Being aware that the learning environment may not be conducive to learning all clinical skills and techniques can also help students early in their education. This can lead to better communication about expectations between the student and the preceptor.

When considering asking a preceptor for a letter of recommendation, Dr. Fisher states that your performance is the number one indicator to consider. If you have performed well throughout your rotation, consider asking for a LoR from your preceptor.

For more information, feel free to contact Dr. Fisher via Twitter and download his free E-book. You can also find more on the Michigan Chapter, Free Market Medicine Association and find Kenneth’s books on his Amazon page or FreedomInHealthcare.org.

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Chase DiMarco

Chase DiMarco is an MS, MBA-HA and MD/Ph.D-candidate. He is the founder of FreeMedEd, a free medical education resource, the host of the Medical Mnemonist 1-Minute Preceptor podcasts by MedSchoolCoach, creator of several medical education platforms, and CEO of FindARotation clinical rotations service.

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