Narrative Healthcare

What Is Working In Healthcare

It is obviously important to call out the nonsense in the healthcare system. But there is so much negativity in the world today and I want to focus on SOLUTIONS.

So, what is actually working in healthcare?

In short, individual providers are the bright spots in the healthcare landscape. When you zoom in and look at the phenomenal people who are actually in the trenches providing care, you see some great things. They are knowledgeable, compassionate and innovative.

I try to be one of these people and I hope to inspire others to do the same. The providers I see (in multiple treatment models) who are doing things well have something important in common.

It is an approach I have come to call "Narrative Healthcare."

This is not completely original to me. There has already been discussion and research around this topic. I know it can sound touchy-feely and unrealistic, but anyone who has actually worked in healthcare and/or been treated as a patient knows how important this is. I hope to shed more light on it and make it less "pie in the sky" and more tangible.

What do these providers do differently? Basically, they listen to their patients, build rapport and establish real context for what is going on. Then they use this context to communicate in a patient-centered way and make a plan to actually help this patient.

This doesn't sound like that high of a bar, but this simple (not easy), step is so important and some providers simply don't (or can't) do it. I want to share a couple examples of providers in different systems that I think are doing this very well.

• Some of you know my Dad has been going through some neurological changes. Without getting into too much detail, he woke up one morning a couple months ago feeling really off and we had to take him to multiple hospitals for assessment. In this process, we met an excellent Neurologist who continues to coordinate Dad's care. Why did we like him so much? He was comprehensive, we immediately felt comfortable with him, he took his time and had a real conversation with us, he was honest and didn't sugarcoat things but was still compassionate and when he had to give a diagnosis he took the time to let us process the way we needed to. The current system has a way of dehumanizing and distancing providers and patients. This Neurologist did the opposite.

• I also want to highlight my friends and colleagues at The Facility in Denver. They are functional medicine providers who practice what they call "middle medicine," blending diet and lifestyle interventions with more traditional medical testing and methods as needed. Their new patient process includes an extensive intake, initial appointment to talk through everything in detail, customized biomarker testing, then a lab review and initial plan. As you can see, this is exactly the kind of process I want providers to be using and it is why I refer to them frequently and personally work with them.

I also work hard to provide this kind of care. Unrushed appointments, continuity of care, real context for programs, advice on recovery, nutrition and lifestyle change and much more.

These are the kinds of providers I want to see more of. If young people want to go into medicine, they need to be focused on driving positive change, not just being another cog in the dysfunctional system.

The providers who are doing the best in the current system have one or two things in common. They work in a specialty that allows/requires them to spend a lot of time with their patients and/or they are providing care in an innovative way.

At this point, many of the best narrative healthcare providers are operating outside the insurance-based system because this allows them to be innovative and patient-centered.

One of the criticisms of this is that not everyone can afford to pay out of pocket. I totally understand this viewpoint and agree with it. But great providers won't make change by martyring themselves and burning themselves out in the current broken system.

They need to step outside the system, build something better (or challenge from within) and force the system to adapt. That is the path to better and more affordable care.

I hope to be a part of this movement.