Industrialisation of medicine

Meagan Brennan writing for BMJ Blogs:

The process of close and active listening without judgment or interruption is a skill that can be learnt. So how can we teach and nurture it? One idea is that the emerging disciplines of medical humanities and narrative medicine can achieve this, through their emphasis on the centrality of the patient’s story to care.1 Academic departments of medical humanities are increasing in number and aim to understand the human experience of illness through the study of poetry, art, and literature. The study of medical humanities is now part of several undergraduate medical programmes in the UK2 3 and the US.1 4 5 Its advocates contend that it can develop empathic practice and a social justice conscience in medical students. It is also being explored as a tool to enhance job satisfaction and reduce burnout in consultant physicians and junior doctors

Meagan makes a coherent argument for medical humanities and encourages readers to “listen to the patients”. Possibly she has an army of transcriptors to type away her queries in EMR’s.

I don’t intend this to be sarcastic, but there is an increasing appreciation for different socio-cultural contexts too. Most public hospitals are understaffed and overburdened, and the covid pandemic has upended the traditional balances. Most patients and their families also rely on non-traditional sources, and the looming threat of the medico-legal cases (along with Yelp-style ranking) has distorted the doctor-patient structures. One doesn’t need research in these – its self goal in pursuit of nothingness. I agree about the art of close listening, but it also eats up the valuable consultation time!

Liberalism suits the contexts where it can be implemented. Else, this would sound like a comedy of errors, instead of a coherent exhortation to repair the doctor-patient relationship. I had hoped Meagan would have provided more context of her own practice, or else this sounds like a hollow promise.

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