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Narratives in Family Medicine: Tales of Transformation, Points of Breakthrough for Family Physicians

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Jeffrey Borkan at Alpert Medical School - Brown University
Jeffrey Borkan
Shmuel Reis at Holon Institute of Technology
Shmuel Reis
Jack Medalie
Jack Medalie
Jack Medalie
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Abstract

Despite the advances in technology, information transmission and evidence-based medicine, the role of the patient's story is still a key to effective medical care. This paper examines the roles of narrative in medicine with particular emphasis on the narrative world of the primary care provider. The focus of this article is on the transforming power of stories and their use in clinical work, teaching, research, and in physicians' personal and professional lives. An organizing model is proposed that utilizes a combination of individual patient narratives, best evidence, and provider narratives. Projections for future threats to narrative medicine and future developments in the field are formulated. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Narratives in Family Medicine: Tales of Transformation,
Points of Breakthrough for Family Physicians
JEFFREY BORKAN, M.D.
SCHMUELREIS, M.D.
JACK MEDALIE, M.D.
Despite the advances in technology,
information transmission and evidence-
based medicine, the role of the patient's
story is still a key to effective medical care.
This paper examines the roles of narrative
in medicine with particular emphasis on the
narrative world of the primary care provider.
The focus of this article is on the
transforming power of stories and their use
in clinical
work,
teaching, research, and in
physicians'personal and professional lives.
An organizing model is proposed that
utilizes a combination of individual patient
narratives, best evidence, and provider
narratives. Projections for future threats to
narrative medicine and future developments
in the field are
formulated.
Fam Syst & Health 19:121-134, 2001
Jeffrey Borkan, M.D., Ph.D., Department of
Behavioral Sciences, Sackler Faculty of Medicine,
Room 907, Tel Aviv University, POB 39040, Tel Aviv,
Israel; 972-3-640-9858; borkan@shani.net.
Schmuel Reis, M.D., Department of Family
Medicine, Bruce Rappaport Faculty of Medicine, The
Technion, Israel Institute of Technology, Haifa, Israel.
Jack Medalie, M.D., MPH, Dorothy Jones
Weatherhead Professor Emeritus, Department of
Family Medicine, Case Western Reserve University
School of Medicine, 11001 Cedar Road, Suite 306,
Cleveland, OH 44106-7136; (216) 368-2758;
junejackm@aol.com.
I
n our practices we experience endless life
dramas-sometimes as observer and
sometimes as active participant with our
patients. We are actors on the stage of
births,
deaths, and all that comes between.
However, how cognizant are we of our role?
How open to the narrative? The ideology
of family and patient-centered medicine
emphasizes the central role of narratives,
but have we utilized this in the past and do
we have a vision for the future? Here we
discuss the role of narratives in medical
practice, teaching and research, while
looking back on our own lives and forward
to future developments.
The focus in this article is on family
practitioners' narratives. We are moving
beyond aesthetics, i.e., the sense of beauty
and artistry in the stories themselves, to
examine their role and meanings-
particularly, how they can document
breakthroughs and transformations in
personal and professional development. This
paper describes an exercise in gathering
transformative stories from family
practitioners from around the
world
1
,
as well
as describing the role of stories in clinical
work, teaching, education, and personal
development. An attempt is also made to
project the direction of medical narratives
in the next decade.
1
These stories are collected in the book, Patients
and Doctors (Borkan, et al., 1999).
121
Families, Systems
&
Health, Vol. 19, No. 2, 2001 © FSH, Inc.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
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