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Scientific, evidence-based medicine is increasingly seen as fundamental to providing effective healthcare, but narrative-based medicine sheds light on social and interpersonal aspects of the practitioner-patient interaction which can also greatly affect healthcare outcomes. The philosophies underlying these two approaches seem to contrast, yet those who can integrate both into their practice are among the most successful medical professionals. Integrating Narrative Medicine and Evidence-based Medicine provides answers to the key question of how medical practitioners can best put both approaches into practice. It anticipates a future where evidence-based practice will be expected of all medical professionals, but contends that the integration of a narrative-based approach will also be crucial, presenting a unique perspective on structuring the patient-professional encounter for optimum results. It develops a cultural analysis and socio-cultural theory of the science of healing, and describes an efficient method by which medical practitioners can find and use medical research at the point of care with current technology and skills. This addresses the need for translational science - moving research into practice - identified by the National Institutes of Health. This book will be essential reading for educators of medical students and postgraduate trainees, behavioral scientists, psychologists, social scientists working in medical settings, and health managers and administrators. Medical students and postgraduate trainees will also find it useful in their learning.
This book presents case-based descriptions of models for the inclusive, multispecialty and multidisciplinary clinical care of complex cases. Cases range from primary care patients with complex systemic medical and psychiatric comorbidity, to those requiring specialty care, to those with potentially terminal illnesses. While each category and case has its unique requirements often necessitating different models of care, the commonalities in approaching complex clinical situations is underscored. Extended case narratives written by the treating physicians, summarizing both the course of clinical care and physicians' reflections on the challenges of managing complex patients, comprise the bulk of the book. Five additional chapters on systems issues associated with care of complex patients, together with a chapter on end of life considerations, a narrative analysis of the physicians reflections about complex patients, and a concluding chapter are prominently included to anchor the case narratives. Written by experts in the field, these descriptions form unique models for assessing and treating complex cases. Integrated Care for Complex Patients is a useful guide for all health practitioners and health administrators who are responsible for clinically complex cases, including physicians in primary care and psychiatry, physician assistants and nurse practitioners, and psychologists.
Edited by two leading general practitioners and with contributions from over 20 authors, this book covers a wide range of topics to do with narrative in medicine. It includes a wealth of real examples of patients narratives and addresses theoretical and practical issues including the use of narrative as a therapeutic tool, teaching narrative to students, philosophical issues, narrative in legal and ethical decisions, narrative in nursing, and the narrative medical record.
The Principles and Practice of Narrative Medicine articulates the ideas, methods, and practices of narrative medicine. Written by the originators of the field, this book provides the authoritative starting place for any clinicians or scholars committed to learning of and eventually teaching or practicing narrative medicine.
How is medical knowledge made? New methods for research and clinical care have reshaped the practices of medical knowledge production over the last forty years. Consensus conferences, evidence-based medicine, translational medicine, and narrative medicine are among the most prominent new methods. Making Medical Knowledge explores their origins and aims, their epistemic strengths, and their epistemic weaknesses. Miriam Solomon argues that the familiar dichotomy between the art and the science of medicine is not adequate for understanding this plurality of methods. The book begins by tracing the development of medical consensus conferences, from their beginning at the United States' National Institutes of Health in 1977, to their widespread adoption in national and international contexts. It discusses consensus conferences as social epistemic institutions designed to embody democracy and achieve objectivity. Evidence-based medicine, which developed next, ranks expert consensus at the bottom of the evidence hierarchy, thus challenging the authority of consensus conferences. Evidence-based medicine has transformed both medical research and clinical medicine in many positive ways, but it has also been accused of creating an intellectual hegemony that has marginalized crucial stages of scientific research, particularly scientific discovery. Translational medicine is understood as a response to the shortfalls of both consensus conferences and evidence-based medicine. Narrative medicine is the most prominent recent development in the medical humanities. Its central claim is that attention to narrative is essential for patient care. Solomon argues that the differences between narrative medicine and the other methods have been exaggerated, and offers a pluralistic account of how the all the methods interact and sometimes conflict. The result is both practical and theoretical suggestions for how to improve medical knowledge and understand medical controversies.
This book explores previously unexamined overlaps between the poetic imagination and the medical mind. It shows how appreciation of poetry can help us to engage with medicine in more intense ways based on ‘de-familiarising’ old habits and bringing poetic forms of ‘close reading’ to the clinic. Bleakley and Neilson carry out an extensive critical examination of the well-established practices of narrative medicine to show that non-narrative, lyrical poetry does different kind of work, previously unexamined, such as place eclipsing time. They articulate a groundbreaking ‘lyrical medicine’ that promotes aesthetic, ethical and political practices as well as noting the often-concealed metaphor cache of biomedicine. Demonstrating that ambiguity is a key resource in both poetry and medicine, the authors anatomise poetic and medical practices as forms of extended and situated cognition, grounded in close readings of singular contexts. They illustrate structural correspondences between poetic diction and clinical thinking, such as use of sound and metaphor. This provocative examination of the meaningful overlap between poetic and clinical work is an essential read for researchers and practitioners interested in extending the reach of medical and health humanities, narrative medicine, medical education and English literature.
This book provides an important contribution to the new and growing field of ‘narrative-based medicine’. It specifically addresses the largest area of medical activity, primary care. It provides both a theoretical framework and practical skills for dealing with individual consultations, family work, clinical supervision and teamwork, and offers a comprehensive approach to the whole range of work in primary care. Using a wide range of clinical examples, it shows how professionals in primary care can help clarify patients’ existing stories, and elucidate new stories. It can be used as a training resource and includes exercises and summaries of key points to consider. It is based on, and describes, an established evaluated training method, and is of immediate and significant practical use to readers. It is essential reading for general practitioners, practice nurses and others in the primary care team, psychologists, family therapists, counsellors and other professionals attached to primary care. GP trainers, tutors and course organisers will find it a valuable educational tool. Professionals elsewhere in primary care such as pharmacists, dentists and optometrists, and academics in medical sociology and medical anthropology will also find it very useful.
How is medical knowledge made? New methods for research and clinical care have reshaped the practices of medical knowledge production over the last forty years. Consensus conferences, evidence-based medicine, translational medicine, and narrative medicine are among the most prominent new methods. Making Medical Knowledge explores their origins and aims, their epistemic strengths, and their epistemic weaknesses. Miriam Solomon argues that the familiar dichotomy between the art and the science of medicine is not adequate for understanding this plurality of methods. The book begins by tracing the development of medical consensus conferences, from their beginning at the United States' National Institutes of Health in 1977, to their widespread adoption in national and international contexts. It discusses consensus conferences as social epistemic institutions designed to embody democracy and achieve objectivity. Evidence-based medicine, which developed next, ranks expert consensus at the bottom of the evidence hierarchy, thus challenging the authority of consensus conferences. Evidence-based medicine has transformed both medical research and clinical medicine in many positive ways, but it has also been accused of creating an intellectual hegemony that has marginalized crucial stages of scientific research, particularly scientific discovery. Translational medicine is understood as a response to the shortfalls of both consensus conferences and evidence-based medicine. Narrative medicine is the most prominent recent development in the medical humanities. Its central claim is that attention to narrative is essential for patient care. Solomon argues that the differences between narrative medicine and the other methods have been exaggerated, and offers a pluralistic account of how the all the methods interact and sometimes conflict. The result is both practical and theoretical suggestions for how to improve medical knowledge and understand medical controversies.
A guide for everyone involved in medical decision making to plot a clear course through complex and conflicting benefits and risks.
The authors demonstrate how therapists can coordinate care with other health professionals dealing with medical problems ranging from infertility to terminal and chronic illness.