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A Champion of Professionalism and Humanism


All things considered, it’s hard not to feel that Paul Lanken, MD, GME ’77, was the best possible choice to speak to this year’s incoming students of the Perelman School of Medicine. As Gail Morrison, MD, GME ’79, the senior vice dean for Education, put it at this month’s White Coat ceremony, one of the primary reasons for the ceremony is to emphasize humanism. As she told the new students, their families, and friends, it may be “the most important and fundamental value in medicine.” Through the ceremony, the students become physicians-in-training, Morrison continued, and it is an occasion to underscore “the primacy of the doctor-patient relationship.”

Lanken holds the distinction of being Penn Medicine’s first associate dean for professionalism and humanism, named to the position in 2004. This year, he became an emeritus professor of Medicine and has also stepped down from his administrative role. But he was a champion of those qualities long before he was associate dean. In his keynote address, he mentioned that during his work in HUP’s Intensive Care Unit (ICU), he often encountered medical and ethical challenges. During that period, he had also served on HUP’s Ethics Committee.

Back in 1995, one of Penn Med’s internal publications ran an article on some critical questions about life support, which can keep a patient alive but also involves painful and invasive procedures. The piece was inspired by an article that same year in The American Journal of Respiratory and Critical Care Medicine; Lanken was one of the authors. He had also helped draft a position for the American Thoracic Society that read, in part: “The purpose of life support is to sustain or restore a meaningful survival, where meaningful refers to a survival that can be appreciated and valued by the patient.” As he told the incoming students this month, what was evident to him at that time was that the challenges medical professionals were facing were not going to go away. One particular insight that came to him from that experience: senior physicians were relying primarily on what Lanken called “the old principle of paternalism.” They paid less attention to newer concepts like patient autonomy and family-centered care. Lanken’s conclusion: medical schools should start ethical training as soon as possible.

As it turned out, Lanken was the right person in the right place at the right time. He had, as he explained at the White Coat ceremony, “a once-in-a-career opportunity.” In the mid-1990s, when the medical school began its extensive rethinking of its curriculum under the overall supervision of Dean Morrison, Lanken was instrumental in designing and implementing its new module on the professional development of the students. The module included stand-alone courses in medical ethics, professionalism, humanism, and the doctor-patient relationship in the first and fourth years. In addition, aspects of professionalism and humanism are taught throughout the four years -- all focused on underscoring the importance of being a compassionate, empathetic, and caring physician.

A Role Model for Students

Two years after Lanken’s appointment as associate dean, Penn Medicine ran an article focused on his role in fostering professionalism and humanism. In the article, Dean Morrison put it in a nutshell: “He is a role model and leader of our students.” But one of the facts Lanken revealed was his own mentor and role model. It was the late Robert L. Mayock, MD ’42, GME ’46, considered “the father of pulmonary medicine at Penn.” For Lanken, Mayock represented “the tradition of the physician with the wonderful bedside manner and the art of medicine.” But Lanken was also careful to point out that humanism in medicine is also about the strength of relationships that a physician has with colleagues, students, friends, and family. “I want our students to learn that it’s about being human: trying to balance your work life; having feelings; going through cycles of your life with other people.”

One of the components that Lanken was instrumental in developing as associate dean is LEAPP (Longitudinal Experience to Appreciate Patient Perspectives), a model for teaching patient-centered care. The program pairs all first-year medical students with chronically ill patients for an 18-month period. In that way, students learn the effects of disease on families and quality of life. As Lanken stated: “Now, first-year students can get right into the trenches, hit the ground running, and see professionalism and humanism in action.”

People -- and organizations -- have noticed Penn’s developments in this area and Lanken’s crucial role in them. He has received the University’s Lindback Award for Distinguished Teaching and the Perelman School’s Special Dean’s Award for Teaching, and he was one of five Gold Humanism Honor Society National Honorees in 2007. As one of the students quoted for the Lindback Award put it: “His thought-provoking approach to medical ethics, implementation of humanistic training, and his unparalleled dedication to students make him a true role model.”

It’s not only current students who admire Lanken. When the Penn Medicine article appeared, one of the letters in response came from Raymond M. Shapiro, MD, GME ’94, PhD. He recalled being a medical intern in Spring 1989, rotating through the medical ICU for a month. One of the people he met on the very first day was Lanken. As Shapiro wrote, “My feeling then, and now, is that he embodies those characteristics of the kind of leader who really does inspire others. . . . Eighteen years later, I still try to envision Dr. Lanken’s attitude/behavior in my own dealings with patients and families, nurses and secretaries, etc.”

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