Lettera al Direttore di Quotidiano Sanità

La Conferenza Permanente dei Presidenti dei Consigli di Corso di Laurea Magistrale in Medicina e Chirurgia (CPPCCLMM&C) ha, negli ultimi dieci anni, sempre più dato ampio spazio a quelle che vengono chiamate “Medical Humanities”. Con questa espressione si intende un insieme di metodi e tecniche didattiche relative all’uso delle arti visive, filmiche, della letteratura, del teatro e della narrazione nella formazione dei medici e degli altri professionisti della salute.

Le Medical Humanities (MHs) si propongono di creare un ambiente educativo in cui sia possibile attivare, in modo congiunto, i processi logici, estetici ed emotivi per recuperare una dimensione quanto più completa dell’essere umano. Il futuro medico deve essere in grado, fin dai primi anni della sua formazione, di guardare oltre lo studio delle malattie ad uno scenario più vasto, in cui salute e malattia hanno implicazioni sociali molto forti e di comprendere profondamente i contesti della cura (sociali, culturali, economici). continua a leggere

Fred N. Pelzman, MedPage Today

In general, I think that good data is a good thing. But is bad data of any use, and is it better than no data at all?

In our lives as healthcare providers, we encounter enormous amounts of data. All day long we are brushed by and inundated with data points, be they individual things like the number of patients on our schedules, or the number of times our patients’ hearts beat as we lay our fingers gently on the wrist to measure their pulses, or listen with our stethoscope to the number of breaths per minute.

Our inboxes and the electronic health record are filled with data, labs that indicate health or illness, or variations about the mean. Is this one dangerous? Is that one bad? Do I need to do something about this? Is this just a fluke?

Due to some internal restructuring, there are an enormous number of new efforts being built or overhauled that look at quality — since this reflects on patient safety — and also for the purpose of regulatory requirements and reporting.

At one meeting this week, we saw data on patient feedback on how our practices are doing, including such items as “Provider listens carefully to you,” “Clerk treats you with courtesy and respect,” and “Phone during office hours answers same day.” (Really, same day? Shouldn’t the goal be one ring or two?) full article

Education in the humanities is important preparation for a career in medicine. Understanding why begins with an appreciation of the critical role of the humanities in enabling each of us to have a more meaningful, thoughtful and insightful life. Through the study of disciplines such as history, philosophy, religion, literature and languages we have unique opportunities to see the world through the eyes of others who have different cultural, social and ethical backgrounds. In so doing, we gain a better appreciation of diversity and ambiguity.

Examining differences in values and reasoning enables us to reflect thoughtfully on the normative framework we have as individuals and as members of a society. The humanities challenge us to question our assumptions, examine our beliefs and develop new ways of thinking about “conventional” wisdom. This appreciation for other modes of thought enables us to see complexity and uncertainty as key elements in the process toward discovering new truths. When viewed in this context, the journey we travel becomes as important as the destinations we reach. 

Education in the humanities also provides us with unique and powerful opportunities to hone our skills of critical analysis and develop clarity of thought and expression. In every pursuit and profession, the expression of ideas is inextricably linked to the formulation of ideas. It is through written and spoken communication that we shape and refine our thoughts.

With this background, we can now inquire as to which of these reasons for studying the humanities are important in preparing for a career in medicine. The unequivocal answer is all of them. Their importance is manifested both in biomedical science and the relationship with and care provided to patients by physicians.

We are in the midst of a biomedical revolution. Multiple scientific disciplines are now focused on questions and problems important to biology and medicine. From genomics to electronic medical records, massive quantities of data about individuals and populations are now available. To obtain meaningful information from these sources requires new processes of analysis based more upon inductive and statistical methods than upon deductive and hypothesis-testing approaches. The nature of truth, the power of these inferences and the actions we should take based upon them are subjects of active discussion among scientists and philosophers alike.

These new challenges and opportunities present a host of ethical dilemmas concerning protection of privacy, consideration of treatment options when knowledge of effects and outcomes is incomplete and ways that risk factors and potential interventions are discussed. We can garner insight into all of these challenging topics from the humanities.

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In addition to these questions arising from the rapid expansion of biomedical inquiry and discovery, there are timeless issues concerning the relationship between caregivers and our patients. Scientific advances have improved our ability to prevent and to treat many conditions, but the list of maladies for which scientifically based approaches is either incomplete or inadequate remains longer than the list of those successfully ameliorated by modern medicine.

Consider the child with autism or the adult with Alzheimer’s disease. A physician can make a diagnosis but cannot offer a cure or a satisfying answer to the question “why?” Even for conditions that we can prevent or treat, patient behavior can significantly impact the success or failure of an intervention. For the hypertensive patient, no amount of prescribed medication will impact the social factors that may be inhibiting lifestyle modification. The specificity of scientific interventions does not account for the messiness of human life.

We as physicians heal best when we listen to and communicate with our patients and seek to understand the challenges they face in their lives. The perspectives on illness, emotions and the human condition we gain from literature, religion and philosophy provide us with important contexts for fulfilling these roles and responsibilities.

In the end, this may be the most compelling reason why the humanities are important preparation for a career in medicine. Through the humanities, physicians and scientists can gain a more complete view of what it means to be human. Across time and space, we have turned to the humanities to find insight into age-old questions and to live more meaningful and thoughtful lives. In this biomedical revolution, we need the humanities now more than ever.

Articolo di Lloyd B. Minor su Stanford Daily