Tailored Presentations: Replies

• Thumri: I like this post and think it is true, but from my experience, all of medical education is designed to help us avoid what you describe as the pain and shame of not knowing. I would be interested to know what you think would be a better way to summarize quickly and communicate about complicated patients.
• ShrinkRants: ...I do wish standard medical practice were different. These tips, and the condensed presentations given as examples, are shot through and through with impersonal “objective” language. Such language hides the subjective nature of its collection. It works directly against any reflection on the discourses that shape what is included and excluded. It is all about knowing. The tips are offered in service of helping presenters look and feel knowledgable and avoid the shame of not knowing. The people the presentations describe are not present as people, as living breathing, hoping, fearing persons. They are reduced to a collection of facts, signs, and symptoms. This is not, cannot in this form be, “patient-centered medicine.” Until we as a profession change our everyday language, we will not be able to practice patient-centered medicine... (Read the rest at http://bit.ly/18M0bDz)
• The shame of not knowing is pervasive but I would agree that it does not mean that it must remain an engrained part of this culture. There are positive ways of delivering feedback. It really depends on the doctor I work with. While subjectivity is generally excluded from these presentations, it helps bring the pertinent information to the forefront, the pieces that are most easily examined, investigated and followed. I always try my best to paint a picture of the person behind the presentation, to tell a story and not just a list of facts. From more descriptors to using a FIFE model to better understand this patient's subjective state, I try to keep them all intact, even if my audience is not completely interested. But the purpose is always to deliver concise presentation that informs enough for another doctor to draw his own conclusions and to do his job effectively. Having said that, some specialties simply do not lend well to subjective language at all in a presentation.