Healing Skills for Medical Practice

Churchill, Larry R.; Schenck, David

doi:10.7326/0003-4819-149-10-200811180-00006

Cited by 112 publications

(43 citation statements)

References 6 publications

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“…With the rise of technological medicine through the nineteenth and into the twentieth centuries, the word “care” seems to have lost much of its richer meaning . Attempting to better understand the tension between technological techniques and caring skills, Larry Churchill and David Schenck identified and interviewed fifty practitioners—not only intensivists but also physicians across a wide spectrum of specialties—who had been nominated by peers as exemplary healers . These fifty physicians were identified as having expertise in the creation and nourishment of patient relationships characterized by compassion and trustworthiness.…”

Section: Dividing Care and Cure: Qualitative Evidence From The Icumentioning

confidence: 99%

Efficient, Compassionate, and Fractured:Contemporary Care in the ICU

Bishop¹,

Perry²,

Hine³

2014

Hastings Center Report

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Alasdair MacIntyre described the late modern West as driven by two moral values: efficiency and effectiveness. Regardless of whether you accept MacIntyre's overarching story, it seems clear that efficiency and effectiveness have achieved a zenith in institutional health care structures, such that these two aspects of care become the final arbiters of what counts as “good” care. At the very least, they are dominant in many clinical contexts and act as the interpretative lens for the judgments of successful health care managers. The drive of efficiency can also be seen in “lean” management methods (originally imported from the automotive manufacturing industry) increasingly deployed in the intensive care unit. This drive gives us pause. The high stress of the ICU is exacerbated by the enormous complexity of technological interventions designed to maintain physiological functioning as the body heals, as well as the ever‐present concerns related to cost, effectiveness, and efficiency. The ICU, therefore, provides an illustrative view of the challenges facing clinicians, as well as resource managers, in terms of delivering care. In short, the goal of technocratic efficiency often ends up at odds with humane purposes. To better understand these contemporary health care dynamics, we conducted a limited series of focus group discussions and interviews with residents experienced in the challenges of delivering care in the ICU environment. In what follows, we highlight some narrative observations drawn from these focus groups. We found a recurrent and disconcerting refrain among our informants that has not been adequately described or addressed in the literature: technocratic management techniques have crept into and bifurcated clinical care strategies in the ICU. Specifically, we highlight the influence of concerns around efficiency and effectiveness and the ways in which these foci have contributed to a bifurcation in care in the ICU along two trajectories: either compassionate care or curative care.

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Section: Dividing Care and Cure: Qualitative Evidence From The Icumentioning

confidence: 99%

Efficient, Compassionate, and Fractured:Contemporary Care in the ICU

Bishop¹,

Perry²,

Hine³

2014

Hastings Center Report

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“…Just as we are all hard-wired for nurturing and caring for others, we all have the intrinsic ability to self-heal from many conditions, to regain the homeostasis that all living organisms seek (F á brega, 1997). In the medical literature the term healing is used largely to describe bodily healing alone (the healing of wounds or the repair of a fracture), but in the complementary and alternative medicine (CAM), lay and healing literatures it has a much wider meaning, being used to describe wholeness, and the integration of body, mind and spirit (Churchill & Schenck, 2008;Egnew, 2005;Kermayer, 2004;Scott et al, 2008). Our trans-disciplinary practice facilitates an engagement with this wider meaning (Bates et al, 2013;Brodzinski, 2010;Goldingay, 2012) .…”

Section: The ' Healing Response 'mentioning

confidence: 94%

‘And the pain just disappeared into insignificance’: The healing response in Lourdes – Performance, psychology and caring

Goldingay

Dieppe

Farias

2014

International Review of Psychiatry

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Three academic/practitioners from different disciplines (performance, medicine and psychology) describe the ways in which observing, and importantly, participating in the healing rituals of the French pilgrimage site of Lourdes challenged their ways of thinking about both their discipline's research approaches and their understandings of community, caring and healing. By positioning themselves as both first-person and third-person researchers, they suggest that a new type of 'trans-disciplinary', longitudinal, reflexively sensitive methodology is needed in order to investigate activities involving groups of people and spiritual practices as a whole system in order to better understand how they can positively affect our innate healing response.

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“…Die an der Behandlung und Betreuung beteiligten Professionals können oftmals nicht angemessen auf die Bedürfnisse der Patienten eingehen. Zum einen lassen DRGs und Fallpauschalen selten eine ausführli-che individuelle Betreuung zu [16]. Zum anderen werden Assessmentinstrumente zur systematischen Erfassung von Symptomen, Beschwerden und Einschränkungen der Patienten noch immer zu selten eingesetzt [17].…”

Section: Hintergrundunclassified