HOW NARRATIVE PRACTICE MAKES ME A BETTER AND HEALTHIER PHYSICIAN

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HOW NARRATIVE PRACTICE MAKES ME A BETTER AND
HEALTHIER PHYSICIAN

• Dr. Barbara True
• Rheumatologist

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HOW NARRATIVE PRACTICE MAKES ME A BETTER AND
HEALTHIER PHYSICIAN

• Dr. Barbara True
• Rheumatologist

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MODEL

• Narrative Practice as a
• Vehicle of Delivery
• for Evidence Based Medicine

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QUESTIONS POSED

• What is Narrative Practice?
• How has NP made me a better physician?
• How has NP make me a healthier physician?

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NARRATIVE PRACTICE

• Inclusive, broad term for wide (infinite?) range
  of all things narrative in a therapeutic context
• Origins of things narrative
• Origins in Narrative Therapy
• Origins in Narrative Medicine
• Practitioner-dependent, by definition

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NARRATIVE THERAPY

• Michael White, David Epston - 1990

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NARRATIVE THERAPY

• A form of Psychotherapy
• Constructivist - clients construct their past by
  stories they tell in the present
• Rejects empirical theories of personality and
  psychopathology.
• Narratives are open, ongoing, never ending
• Stories dont mirror life, they shape it.

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Michael White Paraphrased

• Privileges the Patient as the one who knows most
  about their life, body, health, goals.
• Encourages authority of patient
• Builds on successful solutions patient has
  already discovered and used
• Loiters with intent to offer medical input
• Avoid abuse of power including malcebo effect

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NARRATIVE MEDICINE

• Dr. Rita Charon
• Columbia University (NYC)
• Department of Narrative Medicine, 2000
• Masters program, 2009

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NARRATIVE MEDICINE

• A form of clinical practice
• Definition medicine practiced with the narrative
  competence to recognize, absorb, interpret, and
  be moved by the stories of illness.
• Reading, writing, reflection, sharing
• Quite wordyAcademic literature is literary
  analysis, not easily joined in in the same sense
  that empiric medicine is

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HOW AM I A BETTER PHYSICIAN?

• Treatment pathway for difficult
  patients-eliminates this as a label.
• Ethical transparency
• Optimizes professional behavior guidelines as per
  Medical Board SA?
• Explores the positive limits of best qualitative
  medical practice
• Allows for practitioner individuality and
  inter-collegial discourse in non-scientific
  domains

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More BETTER

• Improves communication skills by changing the
  playing field, or context, rather than teaching
  vague values or principles, ie niceness
• Operates in the social domain of the
  bio-psycho-social model of medicine, bypassing
  judgmental language of psychologies

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HOW AM I A HEALTHIER PHYSICIAN?

• Nurtured by work rather than drained
• Re-balances medical practice better for doctor
  and patient not doctor or patient
• Re-humanizes medical practice human pace, not
  machine pace
• Restores my idealism for why I entered medicine
• Avoids Institutional Aspergers