So, what is the problem with a science-based ob- jective approach? What is being sacrificed or dis - regarded by the physician method? The element of subjectivity is diminished by pure science-based decision-making. Dr. Sackett’s definition of evidence-based medicine includes “the care of the individual patient”, but EBM has evolved into the opposite practice, whereby phy- sicians rely on generalized clinical facts to make decisions. The context behind the patient’s suffer - ing and illness is not considered because physi- cians simply do not have the time to sit and listen. EBM is attractive to overworked physicians who can quickly write a prescription or quick treat- ment based on scientific facts; however, these treatments may not be practical for every patient, as each person has a different degree of suffering and access to different resources. Patients need individualized care, and relying solely on EBM is not fully successful. So, how do we teach physi- cians to incorporate more subjective care, listen, and to communicate differently? The answer lies in the humanities. Narrative-based medicine (NBM), a combination of medicine and the humanities, focuses on the patient narrative, including listening to experienc- es and analyzing their stories to enhance the qual- ity of care (Charon 1898). This patient-centered method allows for patients to play an important role in the understanding of their diagnosis and developing their treatment plan. Narrative-based medicine was devised by clinicians, including Rita Charon at Columbia University and Trisha Green- halgh at King’s College London (Marini 7). Rita Charon defines narrative medicine in terms of physicians developing the trait of narrative com- petence, the competence that human beings use to absorb, interpret, and respond to stories (Cha-
ron 1897). Dr. Charon claims that narrative com- petence allows a physician to practice medicine with empathy, reflection, professionalism, and trustworthiness (Charon 1897). All of these traits are essential to the patient-physician relation- ship, and being narratively competent allows a physician to connect with the patient. Physicians can interpret their knowledge of health facts and research with subjective meaning for each indi- vidual patient. The medical-scientific community is paying at - tention to narrative-based medicine because of three phenomena that have improved society and the quality of care: 1. the emergence of precision medicine and personalized treatments; 2. the shift in the doctor-patient model to a more equal relationship; and 3. the development of new tech- nology that has promoted the sharing of patient narratives (Cenci 22). These changes have sparked curiosity to integrate narrative-based medicine into the traditional evidence-based model. An Italian study in 2016 analyzed more than 1600 studies submitted by scholars and offered a con - temporary definition of narrative medicine: “The term narrative medicine refers to a clinical assis- tance methodology based on a specific commu - nicative competency…Narrative Based Medicine is integrated with Evidence-Based Medicine, and by taking into account the various perspectives, makes clinical assistance decisions more com- plete, personalized, effective, and appropriate” (Cenci 23). NBM is the solution to amending tra- ditional healthcare delivery and making it more effective and efficient. The field of medicine can be compared to a pen - dulum; right now, medicine is shifting back to a patient-centered model. Narrative-based medi-
cine is a method that can refocus medicine by de- veloping the narrative competence of physicians to redefine communication between clinical and non-clinical professionals. Shifting medicine back to a humanistic practice is essential for the qual- ity of care because physicians, who have more in- sight into their patients can gain their trust and provide the most accurate treatment. All popula- tions of patients will benefit from a personalized medical experience, especially the elderly with chronic conditions, because their suffering can be ameliorated, both physically and psychologically. Using narratives as the means of communication improves the dynamics in the clinical relation- ships because people can truly express their feel- ings and provide honest truths in a way everyone can understand. This is pivotal for the physician- patient relationship, because narratives allow patients to directly contribute to the outcome of their care. Why should one consider narrative-based medi- cine? Why does it matter? Many of you are high school or college students, and if you are inter- ested in medicine, trying to position yourself for success in the medical field. Prospective medical professionals should gain narrative competence and focus on developing a humanistic style of medicine because the way that one practices medicine will define your success in the field. The future of NBM is to understand how to teach physicians to be narratively competent. Dr Cha- ron has pioneered the design of a masters curric- ulum at Columbia University that allows medical students to take classes as electives or specialize in narrative medicine. This field is progressing rapidly, and will shape the future of healthcare. The value of the humanities is exponential and
My name is Kartik Nath. I am a neuroscience major with the goal of attending medical school and fulfilling my dream of becoming a physician. Attending a liberal arts school has allowed me to broaden my worldview, become a better thinker, and find the value of the humanities in my life. Other than studying and running on cam- pus, I enjoy reporting on scientific discover - ies in our campus newspaper, playing violin in our campus orchestra, and sharing my love for biology with high school students through our biology club.
improves the field of medicine, and I believe that interdisciplinary work will lead to greater success and delivery of better healthcare.
Cenci, C. “Narrative Medicine and the Personalisation of Treat- ment for Elderly Patients.” European Journal of Internal Medi - cine, vol. 32, Elsevier B.V., 2016, pp. 22–25, 3.Charon, Rita. “Nar - rative Medicine: A Model for Empathy, Reflection, Profession, and Trust.” JAMA, vol. 286, no. 15, American Medical Association, Oct. 2001, pp. 1897–902, / Marini, Maria Giulia. Narrative Medicine Bridging the Gap Between Evidence-Based Care and Medical Humanities . Springer International Publishing, 2016, Sackett, D Ll. “Evidence Based Medicine: What It Is and What It Isn’t.” BMJ (Clinical Research Ed.), vol. 312, no. 7023, Jan. 1996, pp. 71–72,
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