Educational Media Reviews Online

This very interesting little documentary illustrates the dying art of bedside examination and diagnosis by doctors who rely primarily on their experience, careful bedside observations and an ability to communicate sympathetically with each patient as a unique human being. We follow Dr. Valentin Fuster and Dr. Herschel Sklaroff, both eminent and very experienced cardiologists as, together, they make teaching rounds at Mount Sinai Hospital in New York City, accompanied by young resident physicians in training. As they interact with several different patients--including a young woman with a heart transplant, a man with serious complications from sleep apnea, and another aged man who refuses treatment for his heart failure—we observe how effectively both doctors are able to quickly establish a strong rapport with each patient and the ways they pay careful attention to subtle physical signs as well as the words and facial expressions these suffering people use to describe what they are experiencing.

Both of the cardiologists featured in Making Rounds argue strongly that current medical practice standards place too much emphasis on the analysis of data from the results of expensive tests and procedures which are adding hundreds of billions of additional annual expenditures to our healthcare system each year, and which too often lead to the wrong diagnosis and do little to affect patient outcomes. While this is undoubtedly true, it is perhaps a bit unrealistic and optimistic to expect, given our current healthcare system’s perverse array of financial incentives to do more, not fewer, “billable” and profitable tests and procedures, that hospitals will enthusiastically embrace a care system re-centered on “thinking” physicians and other providers with the time, expertise, experience and communication skills demonstrated by these two world-class cardiologists. Nevertheless, the film does a very effective job of demonstrating how patients would certainly be better served by a healthcare system that puts a higher priority on direct communication with, and observation of, patients. Making Rounds is the work of a very experienced team led by director Muffie Mayer whose career started in 1975 with Grey Gardens, the multiple-award-wining, National Film Registry documentary. Without fancy camera angles, special effects, voice over, or animation, these film makers simply and effectively allow us to be close observers of these doctors and their interactions with patients.

The film will be most appropriate for mature general audiences and for healthcare and health systems management professionals in training.