narrative medicine essay

narrative medicine essay

Exploring the Impact of Narrative Medicine in Healthcare

1. Introduction to Narrative Medicine

Professionalism in medicine has been debated and studied in recent years within interdisciplinary areas and areas of expertise such as psychology, humanities, and the arts. These multiple perspectives shed light on the relationship characteristics of this profession with the field of art, including literature. They open doors to experiences in the art world valid to promote growth on a personal and professional level and the improvement of patient welfare. In addition to this information about the patient being essential to diagnosis and treatment, our approach as medical professionals in interview situations becomes crucial. Attitudes such as active listening, empathy, and professional interest lead to benefits derived from achieving a strong patient-physician relationship. On a deeper level, the satisfaction and well-being of the doctors and the patients are enhanced.

Narrative medicine takes a patient’s social and personal story into account during the treatment process. This approach emphasizes the need to critically analyze the stories present in complex interactional contexts such as medicine. Not only does adopting this practice allow healthcare members to relate better with patients, it also directly contributes to diagnosing and treating illnesses. Giving the patient a chance to recount and reflect on their experiences provides valuable medical data referred to as “qualitative data” in a narrow sense while promoting the well-being of the patient and can be referred to as “information with healing.”

2. Theoretical Foundations and Principles of Narrative Medicine

2.2. Principles and Goals of Narrative Medicine The aim of Narrative Medicine is to incorporate principles and goals that include diagnosis, the caring relationship, and contributing to healthcare. Diagnosis can uncover and heal the tensions caused by mind-body separation and appraise the demands patients place upon themselves and others as they respond to the disease. The dialogical relationship of trust, knowledge, and need and keeping the gaze forward, toward a compassionate understanding that values patient encounters as opportunities to learn about the other. The recovery of a healing responsibility within a fraught and dehumanizing field is a medical enterprise that must be acknowledged and repaired if the health of the care is to be restored and improved. Patients who look upon themselves with self-vision that they consider to be empty or impotent to take in the world may derive support from their order to allow them to restore a vision that they can accept as whole.

2.1. Theoretical Foundations of Narrative Medicine Narrative Medicine is an interdisciplinary health-related field with theoretical foundations based in narrative theory, literary studies, and health sciences. Its objective is to enhance consciousness of the role of individual experience in the practice of medicine and to enhance healing relationships between patients and physicians. Leslie Jamison wrote that in place of an incomplete clinical narrative about the patient, what a doctor can give instead is a form of witness, a way of sharing access to the unfolding tragedy, affirming the value of the pain, and helping the patient to endure… attending to the story that suffering impels us to tell. Narrative medicine educates physicians on how to recognize and measure those feelings of being listened to by their patients.

3. Applications of Narrative Medicine in Clinical Practice

In recent years, medicine has become increasingly aware of the complexities of diagnosis, treatment, and patients’ adjustment to current healthcare systems where diseases are chronic, there is a shortage of primary care providers, and there is a need for physician empathy. Accordingly, medical educators and physicians have been working on how to re-cultivate a partnership between physicians and their patients. A natural fit for this patient-physician reunion is to consider patient and physician narratives as an educational tool to enhance physicians’ understanding and communication skills. Since 2000, a growing number of medical programs and graduate concentrations in medical humanities and narrative medicine have been established. As of 2014, the American Association of Medical Colleges reports nearly 50 narrative medicine programs at medical schools in the United States.

The underlying principle of teaching narrative medicine to medical students and practitioners is that they will become better physicians if they know how to hear their patients’ stories. To achieve this goal, various approaches of utilizing the medical humanities, writing, reflection, and healing in the form of creative expression are applied within medical education programs. Clinical practice of narrative listening and narrative retelling as a tool for teaching physical examinations and case presentations has also been utilized. There are benefits of teaching narrative medicine techniques, including improved patient and physician care partnership, inter-professional skill building, improved empathy, self-expression, openness, and healing abilities in physicians.

4. Challenges and Future Directions in Narrative Medicine

Collating specific case studies on how narrative medicine enhances institutional productivity, clinical effectiveness, patient safety, and healthcare finances will provide tangible evidence regarding the benefits of incorporating narrative medicine in healthcare education and practice. As highlighted by teaching strategies, the power of narrative medicine is pedagogic and assumes greater efficacy in settings with more liberal curricular designs and in settings with intrinsic professional relationships and mutual support among faculty, residents, and students. Administrative support and faculty development entitlements for residency and continuing education also hold the key towards more extensive implementation of deep training in narrative medicine. The professional body of educators and practitioners of narrative medicine needs to publish literature attesting to its benefits and hence bridge the gaps between rhetoric and theoretical underpinnings aside practical wisdom. With increasing confidence and strong leadership, narrative medicine will become accepted and appreciated for nurturing productive, inspired, and fully trained physicians who can connect with and guide patients in their unique lives.

As healthcare systems tackle diverse and persistent challenges, narrative medicine, with its focus on patient-provider relationships, reflective practice, and humanistic dimensions of care, is often considered a transformational framework/module within medical or healthcare education. Such a pervasive and transformative approach to healthcare and pedagogy is not free from inherent and unique challenges and resistance. Our current healthcare cultures prioritize clinical knowledge and expertise and expect objectivity in decision-making without considering the emotional and experiential context of patient care encountered by healthcare providers. Time constraints and busy schedules pose significant challenges to the medium throughput of narrative medicine discussions and exercises. Institutions may not have the infrastructure, financial support, and faculty with interest and expertise to drive institutional changes and support these initiatives in curriculum development and assessment. Legal and ethical concerns govern the degree of familiarity that the provider may have with the patient through stories, narratives as documentation, and presence on social media. Wellness, resilience, and the personal and professional life balance of healthcare providers are difficult goals to achieve, but narrative medicine plays a significant role in promoting such aspects.