Optimised physical, mental and social wellbeing in medicine is co-created. Safer, clinically effective, sustainable and person-centered outcomes in wellness can only be achieved in the context of relationships and healthcare communities that are built on social awareness and characterized by compassionate, dynamic communication.
Healthcare systems around the world are, however, plagued by various socio-economic, psychosocial, demographic, behavioral, pathological, professional and system- or policy-driven divides. These divides, together with an inability amongst patients, family caregivers, healthcare professionals and organisations to express, listen to, interpret and act with compassion on experiences in medicine result in the breakdown of relationships and the dwindling of much-needed collaborations. It also leads to ‘compassion fatigue’, professional burnout, complications, traumatic medical experiences, post-traumatic stress disorder and preventable mortalities.
The authors of “The Principles and Practice of Narrative Medicine” talk about the importance of involving patients in their own care and wellbeing, but many hospital experience managers are faced with the seemingly impossible task of marrying patient experience with clinical excellence. Dynamic communication requires dynamic thinking and narrative competence – disciplines that on the surface seem to be in direct contrast of the static thinking required for clinical brilliance.
There is however a small but growing body of evidence that confirms the important relationship between patient experience and clinical effectiveness when it comes to quality healthcare. Research shows that clinical services that are intentionally patient-centered, achieve better clinical outcomes (Boore 1978; Hayward 1975; Shuldham 1999; Suchman 1993). Effective doctor-patient communication furthermore promotes compliance in medication and more active self-management on the patient’s side (Bauman et al 2003). Anxiety and fear have been proven to delay healing, but are allayed by emotional support (Cole-Kind and Harding 2001; Norman 2003; Weinman et al 2008).
My aim as transformative relationship guide in medicine is to help groups and individuals (both patients and health workers) in creating the ideal environments or ‘relational spaces’ for dynamic communication and to grow in narrative competence and self-awareness. By doing so I hope to encourage healthcare that is rooted in person-centeredness, dignity and recognition and that nourishes not only the patients, but also those committing their lives to this noble service.