Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Can narrative medicine inform quality of care?

Don S. Dizon, MD
Physician
April 7, 2014
Share
Tweet
Share

asco-logoAs characterized by Dr. Rita Charon in her JAMA article almost 15 years ago, narrative medicine is “the ability to acknowledge, absorb, interpret, and act on the stories and plights of others.” It is the recognition that scientific knowledge alone is not enough — not enough for our patients, for ourselves, and for society. It stresses the importance of not only hearing what our patients go through, but also to interpret and to respond to their experiences.

Narratives have found a home in journals such as JAMA (A Piece of My Mind), the New England Journal of Medicine (Perspectives), Annals of Internal Medicine (On Being A Doctor), the Journal of Clinical Oncology (Art of Oncology), and on online communities, such as ASCO Connection. Beyond exercises in creative writing, I think these opportunities serve to emphasize that medicine is and will always be an art, and that is as important as our quest for evidence. After all, it is the human element of medicine that cannot be converted into an algorithm or modeled with even the most sophisticated computer program.

My blogs and tweets (which are really microblogs — stories told in 140 characters) reflect what I’ve read, impressions I have had, and thoughts I want to share.

Both are exercises in writing, and though I never thought of myself as a writer (still don’t in fact), I find it has given me a way to share my own experiences in medicine and the rich interactions I have had with colleagues. It has allowed me to contribute to a larger sense of community. These are not opinion pieces, but rather reflect my choice to practice narrative medicine.

I will admit that I write with hope that one who reads my words may take something away from it; that it will have even a small impact. However, looking back, perhaps the one changed the most is not a reader–it is me. Writing has informed how I interact with my kids and my friends, and how I practice oncology. It has helped me to realize how precious time is — to actually look up and appreciate the sun shining; to stop and smell the roses. In so doing, I am more cognizant of the words I use, the approach to take when discussing evidence. In short, it has impacted on my lived experience of medicine as an art.

I wonder if narrative medicine may serve an even more important goal though — is it possible that our narratives could inform quality of care? Maybe by sharing our stories and giving a voice to experiences, we can inform the goals and preferences of our patients, and allow their voices to be considered in the weight of evidence and the analyses on cost effectiveness. By reminding us to pay attention to what our patients tell us, could narrative medicine help guide the weighty issues that we are dealing with as oncologists, clinicians, patients, advocates, and as a society?

For example, the use of narratives can lend voice to the urgency to participate in clinical trials. One story I shared in ASCO Connection was of two women who participated in a randomized trial — one who survived and one who did not. The message was that trials are important, told in the sharing of experiences of two trailblazers. I cannot tell you precisely how many times it was viewed, but it did stimulate some really good discussions, which played out online on KevinMD.com and on Twitter. Perhaps if each clinician shared a story, we could increase the rates of trial participation in the future.

I certainly do not think all of us are meant to be writers, nor do I suggest that it should be a mandatory practice for all clinicians. But I do think each of us has something to share. Perhaps by doing so, one can learn a little bit more about him or herself in the process. That in and of itself is a worthy goal.

There is one question I am asked, though, that I do find myself coming back to — with each blog I write and each tweet I send: “Who are you writing for”? To this question, the literary critic and writer Cyril Connolly said it best: “Better to write for yourself and have no public, than to write for the public and have no self.”

Don S. Dizon is an oncologist who blogs at ASCO Connection, where this post originally appeared.

Prev

An erosion of privacy in health care settings

April 7, 2014 Kevin 6
…
Next

Why this cardiologist mourns the death of the stethoscope

April 7, 2014 Kevin 4
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
An erosion of privacy in health care settings
Next Post >
Why this cardiologist mourns the death of the stethoscope

ADVERTISEMENT

More by Don S. Dizon, MD

  • As an oncologist, this is the hardest role I play

    Don S. Dizon, MD
  • Why physicians should acknowledge the validity of second opinions

    Don S. Dizon, MD
  • A patient who taught an important lesson in doctoring

    Don S. Dizon, MD

More in Physician

  • Personalized scientific communication: the patient experience

    Dr. Vivek Podder
  • From law to medicine: Witnessing trauma on the Pacific Coast Highway

    Scott Ellner, DO, MPH
  • Why doctors struggle with treating friends and family

    Rebecca Margolis, DO and Alyson Axelrod, DO
  • A simple nocturia management technique for seniors

    Neil R. M. Buist, MD
  • Lessons on leadership from a Navy surgeon and NFL doctor

    David B. Mandell, JD, MBA
  • Sjogren’s, fibromyalgia, and the weight of invisible illness

    Dr. Bodhibrata Banerjee
  • Most Popular

  • Past Week

    • Why patient trust in physicians is declining

      Mansi Kotwal, MD, MPH | Physician
    • “The meds made me do it”: Unpacking the Nick Reiner tragedy

      Arthur Lazarus, MD, MBA | Meds
    • Why insurance must cover home blood pressure monitors

      Soneesh Kothagundla | Conditions
    • Is tramadol really ineffective and risky?

      John A. Bumpus, PhD | Meds
    • The dangers of oral steroids for seasonal illness

      Megan Milne, PharmD | Meds
    • 5 things health care must stop doing to improve physician well-being

      Christie Mulholland, MD | Physician
  • Past 6 Months

    • Why patient trust in physicians is declining

      Mansi Kotwal, MD, MPH | Physician
    • The blind men and the elephant: a parable for modern pain management

      Richard A. Lawhern, PhD | Conditions
    • Is primary care becoming a triage station?

      J. Leonard Lichtenfeld, MD | Physician
    • Psychiatrists are physicians: a key distinction

      Farid Sabet-Sharghi, MD | Physician
    • Why feeling unlike yourself is a sign of physician emotional overload

      Stephanie Wellington, MD | Physician
    • Accountable care cooperatives: a community-owned health care fix

      David K. Cundiff, MD | Policy
  • Recent Posts

    • Personalized scientific communication: the patient experience

      Dr. Vivek Podder | Physician
    • From law to medicine: Witnessing trauma on the Pacific Coast Highway

      Scott Ellner, DO, MPH | Physician
    • Why doctors struggle with treating friends and family

      Rebecca Margolis, DO and Alyson Axelrod, DO | Physician
    • The emotional toll of leaving patients behind

      Dr. Damane Zehra | Conditions
    • Peripheral artery disease prevention: Saving limbs and lives

      Wei Zhang, MBBS, PhD | Conditions
    • Artificial intelligence ends the dangerous cycle of delayed patient care [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why patient trust in physicians is declining

      Mansi Kotwal, MD, MPH | Physician
    • “The meds made me do it”: Unpacking the Nick Reiner tragedy

      Arthur Lazarus, MD, MBA | Meds
    • Why insurance must cover home blood pressure monitors

      Soneesh Kothagundla | Conditions
    • Is tramadol really ineffective and risky?

      John A. Bumpus, PhD | Meds
    • The dangers of oral steroids for seasonal illness

      Megan Milne, PharmD | Meds
    • 5 things health care must stop doing to improve physician well-being

      Christie Mulholland, MD | Physician
  • Past 6 Months

    • Why patient trust in physicians is declining

      Mansi Kotwal, MD, MPH | Physician
    • The blind men and the elephant: a parable for modern pain management

      Richard A. Lawhern, PhD | Conditions
    • Is primary care becoming a triage station?

      J. Leonard Lichtenfeld, MD | Physician
    • Psychiatrists are physicians: a key distinction

      Farid Sabet-Sharghi, MD | Physician
    • Why feeling unlike yourself is a sign of physician emotional overload

      Stephanie Wellington, MD | Physician
    • Accountable care cooperatives: a community-owned health care fix

      David K. Cundiff, MD | Policy
  • Recent Posts

    • Personalized scientific communication: the patient experience

      Dr. Vivek Podder | Physician
    • From law to medicine: Witnessing trauma on the Pacific Coast Highway

      Scott Ellner, DO, MPH | Physician
    • Why doctors struggle with treating friends and family

      Rebecca Margolis, DO and Alyson Axelrod, DO | Physician
    • The emotional toll of leaving patients behind

      Dr. Damane Zehra | Conditions
    • Peripheral artery disease prevention: Saving limbs and lives

      Wei Zhang, MBBS, PhD | Conditions
    • Artificial intelligence ends the dangerous cycle of delayed patient care [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...