Thursday Review: “Patients as Story-Tellers of Healthcare Journeys”

Klay Lamprell and Jeffrey Braithwaite use one of my favorite words when talking about stories: “structure”. Writing in Medical Humanities, the authors discuss two complimentary ways to help patients express their own story. The first is a structural approach, and the second is more character-driven.

The purpose of the article is to bring these techniques to light. The authors do briefly discuss what makes these stories powerful, though. Stories can be longitudinal: they reach experiences across silos of care over periods of time.

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Thursday Review: “Slowing Down Fast Thinking to Enhance Understanding”

Daniel Kahneman and Amos Tversky more or less invented what we now call Behavioral Economics. Tversky passed away in 1996, but Kahneman went on to win the Nobel Prize and his 2011 bestseller, Thinking, Fast and Slow, brought their work to the general public. The big question Kahneman continuously answers in the book is, “How is it possible that we can make decisions that aren’t in our best interest?”

Bringing fast and slow thinking into medicine, Edmund G. Howe describes how he took Kahneman’s ideas and used them to guide patients through difficult decisions in The Journal of Clinical Ethics.

In his article, Howe makes useful and sincere applications to medical ethics and patient care. Going through his work also makes me want to re-read Kahneman’s book.
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Thursday Review: “Soliciting the Patient’s Agenda: Have We Improved?”

What would a consultation look like if a patient were able to voice all of their concerns? Asked in a different way, how can we quantitatively demonstrate the benefits of a consultation where a patient is allowed to simply speak freely?

Writing in The Journal of the American Medical Association, Dr. M. Kim Marvel et al. give some rich detail and answers. They use a slightly different approach to “agenda” than Barry et al. did in their work on unexpressed patient agenda items. This paper, though, comes to the same general conclusion: that being intentional about hearing all that a patient has to say makes healthcare more effective, not less.

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Thursday Review: “Patients’ unvoiced agendas in general practice consultations: qualitative study”

In the discussions about how to bring the humanities into medicine, one essential feature often gets lost. The attempts to make care more human and more humane aren’t being done for the sake of warm fuzzies. There are concrete ways medical outcomes suffer when healthcare practitioners and patients aren’t communicating well.

Writing in The BMJ, Christine A. Barry, et al. provide one of the clearest discussions on medical outcomes suffering from ineffective communication, and why both patients and doctors are hesitant to change communication for the better.
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Thursday Review: “Teaching communication skills to clinical students”

In a section of the BMJ under the header How To Do It, Ian Christopher McManus, Charles A. Vincent, S. Thom, and Jane Kidd offer practical advice from their experiences teaching communications to students at St. Mary’s Hospital Medical School.

I’m certainly not running a medical school, but there are still some interesting, practical ideas to be gleaned from the authors’ experiences.
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Thursday Review: “Performing Narrative Medicine”

I was initially interested in Kristin M. Langellier’s article because of the idea of performance. The main project of my work in medical storytelling has been to take the ideas bound up in Narrative Medicine and apply them to face-to-face interaction. With Narrative Medicine, my concern has always been that narrative skills are often parallel to, and not a part of, clinical practice.

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Thursday Review: “Why Are Medical Journals So Dull?”

For something a little different, this February, the Thursday Reviews will be dedicated to a few of Richard Asher’s classic articles from the late 1950s:

Writing in the British Medical Journal in 1958, some of Richard Asher’s ideas concerning “Why Are Medical Journals So Dull?” are certainly products of their times. Others, though, are still valid and instructive today.

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