Inui Thomas S, Frankel Richard M
Regenstrief Institute, Indianapolis, Indiana, USA.
Acad Med. 2006 May;81(5):415-8. doi: 10.1097/01.ACM.0000222272.90705.ef.
The authors use the concept of "samaritan medicine" to tie together papers by Klitzman, by Wear and colleagues, and by Branch appearing in this issue of Academic Medicine on the physician-patient relationship. Practicing physicians and trainees alike must confront the challenge of acknowledging and connecting to otherness or difference in patients and in themselves, and practice based in "samaritan medicine" can help to bridge the gaps between self and other. The authors present three vignettes that highlight physicians' and patients' differing perspectives on the stories in which they are mutually involved. The authors then suggest three approaches that operate at the organization as well as the individual level and that speak to establishing and sustaining health-supporting relationships between patients and doctors: video review and replay, Appreciative Inquiry, and self-disclosure. The aim of such approaches is that physicians and physician-trainees be able to ask-and answer-questions about the "narratives" they are enacting, such as "In this story, where am I? Where is the other? Where is the common good? What, then, should I do?" in order that they may develop a robust appreciation of patient interactions and understanding of self that fosters the practice of "samaritan medicine."
作者运用“撒玛利亚人医学”的概念,将克里茨曼、韦尔及其同事以及布兰奇在本期《学术医学》上发表的关于医患关系的论文联系起来。执业医师和实习生都必须面对承认并与患者及自身的他者性或差异建立联系这一挑战,而基于“撒玛利亚人医学”的实践有助于弥合自我与他者之间的差距。作者呈现了三个案例,突出了医生和患者对他们共同参与的故事的不同看法。作者随后提出了三种在组织和个人层面都适用的方法,这些方法有助于在患者和医生之间建立并维持支持健康的关系:视频回顾与重放、积极探寻以及自我披露。这些方法的目的是让医生和实习医生能够就他们正在演绎的“故事”提问并回答问题,比如“在这个故事中,我在哪里?他者在哪里?共同利益在哪里?那么,我该怎么做?”,以便他们能够充分理解患者互动并认识自我,从而促进“撒玛利亚人医学”的实践。