Using medical storytelling to communicate problems and solutions in the low back pain conundrum: an evidence-based tale of twins

Chiropractic & Manual Therapies

Commentary

Jeffrey Borkan¹  Donald R. Murphy²  Brian D. Justice³ 

[1]Department of Family Medicine, Alpert Medical School of Brown University, 111 Brewster St, 02860, Pawtucket, RI, USA

[2]Department of Family Medicine, Alpert Medical School of Brown University, 133 Dellwood Road, 02920, Cranston, RI, USA

[3]Excellus BlueCross BlueShield, 165 Court Street, 14647, Rochester, NY, USA

关键词: Low back Pain;    Neck Pain;    Healthcare System;    Health System incentive;    Healthcare Problem-Solving;    Patient-centered care;    Relationship-centered care;    Medical narratives, Health Care Reform;    Primary care;    Health Policy;    Learning Health Systems;    Spine;   

DOI  :  10.1186/s12998-023-00499-9

 received in 2022-12-15, accepted in 2023-07-14,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectivesLow back pain (LBP) is the number one cause of disability world-wide. It is also the most expensive area in healthcare. Patient-centered innovations are needed. This paper uses medical storytelling to illustrate the common problems that often lead to unnecessary suffering for patients, and costs to society. We present innovative solutions, including narrative interventions.MethodsWe use medical storytelling to present a scenario in which hypothetical twin patients with identical LBP episodes enter the healthcare system, with one twin managed in an appropriate manner, and the other inappropriately.ResultsOne twin becomes a chronic LBP sufferer, while the other experiences quick resolution, despite identical conditions. Recommendations are made to de-implement inappropriate action and to implement a more productive approach.ConclusionsMany patients with LBP descend into chronic pain. This is rarely inevitable based on clinical factors. Much of chronic LBP results from how the condition is handled within the healthcare system. Medical narrative may be one innovation to illustrate the problem of current LBP management, recommend solutions and foster changes in clinical behavior.Practical implicationsThe starkly different outcomes for each identical twin are illustrated. Recommendations are made for reframing the situation to de-implement the inappropriate and to implement a more appropriate approach.

【 授权许可】

CC BY   
© Chiropractic and Osteopathic College of Australasia, European Academy of Chiropractic, The Royal College of Chiropractors, Nordic Institute of Chiropractic and Clinical Biomechanics and BioMed Central Ltd. 2023

【 图 表 】

Fig. 6