The Clinical Reasoning Series - Narrative ways of hearing and knowing with Sanja Maretic
Apr 21, 2022
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Sanja Maretic, an osteopath and pain clinician, discusses the role of narratives in healthcare, the concept of structural competency, and the importance of incorporating the arts and humanities in healthcare education. They explore narrative thinking in clinical care, emphasizing the significance of listening and understanding in healthcare. The chapter also discusses the importance of touch in understanding patient backgrounds and highlights the challenges of finding a role in the pain service.
Understanding patients' narratives is essential for providing holistic care and considering the social structures surrounding their lives.
Structural competency helps healthcare professionals appreciate the complex social contexts and structures that influence people's health and recovery.
Incorporating arts, poetry, and humanities in healthcare education expands the therapeutic approach beyond the biomedical and widens the clinician's gaze.
Deep dives
The Intersection of Healthcare and Humanities
Sanya Maritich, an osteopath working as a pain clinician, discusses the intersection between healthcare and humanities. She emphasizes the importance of understanding patients' narratives and the role of narratives in the care of people. Sanya believes that incorporating the arts, poetry, and humanities into healthcare education can broaden the therapeutic approach beyond the biomedical. She also emphasizes the significance of listening to patients' stories and understanding the social structures that influence their health and recovery.
Structural Competency and Narrative Medicine
Sanya explores the concept of structural competency, which involves recognizing and responding to the ways social, political, and economic structures contribute to vulnerability and ill health. She highlights the importance of understanding the social context and structures that shape people's health, illness, and pain. Sanya emphasizes the need for healthcare professionals to listen intently to patients' narratives and consider the systemic and structural factors that impact their health. This approach goes beyond traditional listening skills and requires a broader awareness of the social determinants of health.
Appreciating Diversity in Clinical Practice
Sanya discusses the importance of acknowledging and appreciating diversity in clinical practice. She highlights how clinicians should be aware of their own biases and prejudices and actively work to understand the experiences and contexts of patients from different backgrounds. Sanya believes that cultural competency is essential in providing patient-centered care and emphasizes the need for clinicians to educate themselves about patients' demographics and social environments. By actively listening and respecting patients' narratives, clinicians can better understand their unique needs and experiences.
The Value of Listening with Hands
Sanya reflects on the role of touch in clinical practice, particularly within manual therapies. While touch can be important in establishing connection and effective care, Sanya emphasizes the need to move beyond reductionist views that focus solely on biomechanics. She notes that touch should not be divorced from the social and cultural contexts in which it occurs. Sanya encourages healthcare professionals to consider the broader narratives and experiences of patients and understand that touch can elicit different responses and meanings for each individual.
Challenges in Finding a Role in Pain Management
Sanya shares her personal journey in finding her way into a multidisciplinary pain management role. She discusses the barriers and challenges she faced due to profession-specific rigid structures. Sanya advocates for breaking away from these rigid structures and recognizing the value of clinicians from diverse backgrounds and experiences. She highlights the importance of seeing clinicians as individuals with unique perspectives and expertise, rather than just as representatives of their professions. Sanya believes that exploring the broader knowledge beyond traditional healthcare education can enhance understanding and improve patient care.
Welcome to another episode of The Words Matter Podcast.
In this episode of the clinical reasoning series, I’m speaking with Sanja Maretic. Sanja is an osteopath who works in a non-traditional osteopathic role as a pain clinician in the pain management service.
Sanja has a background in humanities and passion for the intersection between healthcare and humanities and as such she published a qualitative study titled “Understanding patients' narratives” A qualitative study of osteopathic educators’ opinions about using Medical Humanities in undergraduate education (see paper here). And Sanja wrote a truly captivating review for the CauseHealth book which I have linked here.
So on this episode we speak about,
Narrative-based approaches and the role and function of narratives in the care of people.
Structural competency (see paper here by Metzl and Hansen) as a framework to appreciate the complex social contexts and structures which guide people health, illness and recovery (see paper on narrative humility here by DasGupta).
How hearing our patients’ narratives enables us to know and see them, the social structures surrounding their lives and environment
How narrative analysis can be used to think critically about our practice and the narratives which surround our clinical realities.
How incorporating the arts, poetry and humanities into healthcare education will help widen the therapeutic gaze of clinicians beyond the mere biomedical.
Sanja’s experience of journeying and finding her way into a multidisciplinary pain setting.
The notion of ‘listening hands’ in relation to touch and palpation in manual therapy and how this may or may not facilitate the construction and understanding of a person’s narrative and life-world.
This was such a wonderful conversation; Sanja speaks truly as a clinician in the way she passionately describes her work and her endeavour to better understand and the lives of those people she cares for.