Model Patient Helps Train Ohio State Med Students

If Tamara LeClaire Reichenbacher were a vision of health she wouldn’t be doing her job, because she is paid to play sick.

Reichenbacher, 29, simulates the symptoms of infectious mononucleosis so that medical students can learn to be good doctors. She is one of several “standardized patients,” who feign illness for medical students at the Ohio State University College of Medicine.

Professors say the pseudo patients teach students to be better listeners, questioners and examiners, and the students also learn how to make a patient comfortable. They also learn that what is said often isn’t as important as how it is said.

Reichenbacher bones up on medical terminology and procedures but has had no theatrical training. When she portrays a patient with mononucleosis, she slumps down in her chair, yawns repeatedly and complains of fatigue.

She doesn’t volunteer all of her symptoms. Students must ask the right questions to get her to mention swollen glands, a scratchy throat and a dull ache in her side.

Faking some illnesses can be a challenge. One man has been taught to expand just one lung when he breathes to duplicate the physiology of a patient with lung cancer, said Dr. Jeff Weiland, an assistant professor of internal medicine.

Reichenbacher said that beginning medical students have one common fault.

“Seeing the patient as a whole person is what some of these students need to learn,” she said. “Sometimes, I’ve had students who come in and start poking and prodding, without saying anything to me first.”

One recent day, first-year students interviewed Reichenbacher at half-hour intervals between 9 a.m. and noon. From 2:30 p.m. on, she was examined and questioned by third-year students.

Reichenbacher works about 40 hours a month in the part-time job and is paid $9 an hour when she works as a pseudo patient. At other times she trains other model patients, a job that pays $8.50 an hour.

Acting sick all day can be tedious, she said, but she is gratified “when I can see the student’s light come on, when I can see they’re learning.”

Patrick Ward, who recently played doctor to Reichenbacher as patient, said he appreciates her efforts.

“Let’s face it. Most of us are going to blunder through this,” Ward said. “She just keeps feeding the rope out.”

Reichenbacher began playing sick at the University of Arizona in 1982. “I had just graduated from college,” she said, “and a friend of mine who was a medical student knew I was desperately looking for a job.”

Seth Kantor, associate dean for medical education, said the pseudo patient fills a void in modern medicine:

“In the good old days, a patient would be admitted Monday for surgery; everybody would interview them Monday; the operation would be Tuesday and they’d stay around five days.

“Now, they’re in and out so fast the students don’t get to see them.”