Medical Humanist Communication Model ™
“Getting the voice of the patient into the history of present illness will not only help to right the medical record, but also help to right the relationship of physician and patient.”
William Donnelly, MD
In 2002 the Institute of Medical Humanism defined, developed and implemented a new position, that of the “medical humanist,” as a member of an interdisciplinary healthcare team at a regional cancer center in Vermont. This individual, a writer by trade, documented the patient’s experience of illness in his or her own words, thereby introducing that information into the medical record. Attending physicians were then asked to review this information and sign off on it. This process gave both doctor and patient the opportunity to communicate more freely, clarifying assumptions and expectations.
Surveys conducted over the course of the pilot program indicated that these efforts had a significant impact on patients’ satisfaction with the quality of their care.
Why was this new role so important? Because informed medical decision-making is dependent on clear communication. And yet the language that patients use to describe their experiences is qualitatively different than that used by physicians. The clinical language that is traditionally logged on patients’ charts is representative of medical professionals’ understanding of illness, rather than reflective of any specific patient’s individual experience. When the patient’s own views and experience are included in the medical record, it offers physicians and nurses the opportunity to review that documentation and address unspoken concerns or misunderstandings.
This pilot program, implemented from 2002 to 2005, proved of benefit to patients, families, medical staff and the institution itself. Bridging existing communication gaps fostered collaborative healthcare decision-making, which in turn helped to improve patients’ satisfaction with care. The inclusion of a medical humanist on hospital committees added a perspective to discussions about ethics issues and palliative care services that had an influence on the culture of the institution and its patient care policy. The creation of this new role resulted in the development of a practical and effective method to resolve the tension between the science of medical practice and the humanistic art of compassionate care.
Understanding that most institutions do not have the resources to support a dedicated medical humanist for their patients, CCM has made it its mission to develop tools for patients and healthcare professionals that will help share the lessons learned from the Medical Humanist pilot program: that illuminating the individual person’s experience, needs and expectations can facilitate clearer communication and strengthen healthcare partnerships. Writing is Good Medicine is one such tool. It builds on the medical humanist’s role and helps activate patients to document their own questions and concerns in a structured format that can serve as reference points for focusing conversations about their care.
Feedback from Physicians & Nurses on the Medical Humanist Pilot Program
“As doctors, we tend to use medical language as an objective cloak—keeping us one step removed from our patients. By raising our awareness of how patients hear and interpret what we are saying, the medical humanist has helped us communicate with greater empathy—and in so doing, to gain deeper insight into our own experience as physicians.”
Letha Mills, MD
Southwestern Vermont Regional Cancer Center
“I see the irony but also the necessity that in an age of ever- increasing medical specialization, there would be a need for someone whose specialty would be injecting humanism back into medicine. The technology has advanced so quickly that physicians have to spend all their time dealing with technical, biological and therapeutic aspects and have little time to deal with the patients as a whole person.”
H. James Wallace, Jr., MD
“Institute emphasizes human side of medicine”
Rutland Herald (VT)
“The addition of medical humanism to our cancer care programs has added new and welcome dimensions to the care from the perspective of both the patients and the physicians. The exploration of the meaning of our words, even our body language has enhanced the process of communication from both ‘sides’, allowing patients to achieve a deeper understanding of their illnesses, themselves, and their physicians. The physicians have a new resource to broaden their ability to communicate with patients, understand the patient experience, and even understand the doctor experience differently, and more deeply.”
Mark Novotny, MD, FACP
Chief of Staff, Southwestern Vermont Health Care
“Your work in bringing the patient’s voice into the medical encounter, while at the same time supporting the physician, helps to bring back the joy and satisfaction in everyday medicine and helps both physician and patient act as partners in the healing process.”
Carol Mahon Salazar, MD
VA Clinic/ Vermont Veterans Home
“The Institute of Medical Humanism has made a singular and valuable contribution to patient care in the world of cancer and beyond. They are unique in that they seek to build bridges between the patient’s view of illness and the medical professional’s approach to care. They are truly devoted to furthering understanding; negotiating perspective and promoting clear communication and good relations between the patient and medical staff.”
Lidia Schapira, MD
Massachusetts General Hospital Cancer Center
Harvard Medical School
“These are my observations about the patient-medical humanist interaction: My imagery is of a human bridge connecting the patient to the doctor. The benefit that I could see was that the medical humanist really found out what the patient understood about her disease, treatment, and her support options. It’s important work.”
Julie Bowen, RN
Southwestern Vermont Medical Center