Although patient history questions frequently reveal the details of a patient's disease, they fail to incorporate the story of the patient experiencing the illness, often leaving the most potentially beneficial stories cut short, Ersilia DeFilippis, MD, resident physician in internal medicine at Boston-based Brigham and Women's Hospital, argues in The Washington Post.
"When we look at the medical chart, we can read multiple notes without learning any information that tells us who our patients really are," Dr. DeFilippis wrote. "But what if we could sit down with our patients for an hour and learn about them as people?"
To explore this issue, Dr. DeFilippis cited a program started in 2013 by psychiatrists at the Madison, Wis.-based Veterans Affairs hospital called My Life, My Story. Through the program, veterans tell their story through interviews conducted by volunteers, social work interns, medical students and staff. The VA offers the program at 18 medical centers, and plans to implement the program nationally.
The veterans write the stories, which are roughly 1,000 words, in first person. No medical questions are involved. Potential interview questions include: "What has been the most significant change you've seen in yourself? What is most important to you? What are you most grateful for? What do you want your healthcare team to know that they don't already know?"
After the interviewer writes the story and shares it with the patient, the story is kept in the VA's EMR so VA providers can easily access it. For Dr. DeFilippis, this program provoked the question: "Why don't all hospitals have this program?"
"The model is a fairly simple one to duplicate," Dr. DeFilippis wrote. "By mobilizing community resources, our patients' stories can be captured by community volunteers who don't need to be skilled healthcare providers. We can learn more about our patients and help them leave a legacy."
Stories can not only help patients heal emotionally and physically, but can also help both physicians and patients reflect on how they have experienced suffering, Dr. DeFilippis added. "This process reminds our patients that their stories are unique and gives them a legacy."
The stories also help providers be more aware of the patients they are caring for and may protect against physician burnout. By knowing more about patients' backgrounds, providers can be more connected and engaged with patients and their own work, Dr. DeFilippis wrote. "We can truly live the 'patient-centered care' that we talk of."