Stories are sewn into every part of medicine.
The way we are trained to talk to patients is about drawing their story out of them. The way we share cases with colleagues is about describing the narrative of a patient.
But modern medicine, especially in this age of EHRs and silos, tends to reduce patients to treatments and boils stories down to a series of interventions. And this weakness might feel more "efficient" at first but does tend to erode the quality of care our patients receive -- as well as the results they may experience from that care.
That said, there are programs and tools that intend to reintegrate patient stories into our work. A recent article in the New York Times told of a program at Weill Cornell Medicine in New York. To combat ageist biases and practices, the program brings in older people to speak to medical students about their experience. Like all people, older patients have a diversity of experiences, strengths, and challenges. And for doctors to care for them well, they need to be able to understand this diversity, and create a care plan within that knowledge.
As Dr. Adelman, the coordinator of the program, says, "Unfortunately, most education takes place within the hospital. If you’re only seeing the hospitalized elderly, you’re seeing the debilitated, the physically deteriorating, the demented. It’s easy to pick up ageist stereotypes.” This program aims to complement this more hospital-based perspective with the other facets of patients' experiences.
Unfortunately, this type of program is still rare. And rarer still are tools that support the full, holistic story of patients as the center of care -- especially once healthcare providers are outside of an academic setting and in the flow of practice.
Electronic Medical Records, text messaging, and other intervention-focused tools only serve to create a further lack of "story" in patient care. But when you don't have the full story of a patient -- including their dreams, goals, daily habits, health goals and other "ancillary" aspects -- you don't necessarily have the full picture of how best to treat them.
Certainly, many aspects of medicine pull us, as providers, away from stories and towards interventions. But when we use a telemedicine-based medical collaboration tool -- like iClickCare -- to have fulsome conversations with other providers about patients and share the holistic picture of whom the patient is, we provide better care and experience more satisfaction. So whatever our medical education provided or did not provide in this way, we always have the choice to use tools to practice medicine in the way that best fits our values. And for me, that has meant a tool that helps me do medical collaboration and see patients as full people.