Annals Journal Club: A Patient-Physician Journey

doi:10.1370/afm.1264

The Annals of Family Medicine encourages readers to develop a learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care and then acting on those discussions.¹

HOW IT WORKS

In each issue, the Annals selects an article or articles and provides discussion tips and questions. We encourage you to take a RADICAL approach to these materials and to post a summary of your conversation in our online discussion. (Open the article online and click on “TRACK Comments: Submit a response.”) You can find discussion questions and more information online at: http://www.AnnFamMed.org/AJC/.

CURRENT SELECTION

Article for Discussion

de Schweinitz P. Nasruddin and the coin. Ann Fam Med. 2011;9(3): 268–270.OpenUrl Abstract/FREE Full Text

Discussion Tips

This issue’s Annals Journal Club article is an essay that depicts both a patient story and the journey of the resident caring for her. Rather than using epidemiological or ethnographic standards to analyze the article, an essay calls for different standards for truthfulness, rigor, and relevance. Use this article to engage both the left and the right sides of your brain. Analyze and apply and reflect with both your head and your heart.

Discussion Questions

What topics are addressed by the article? How do the questions fit with what you have been taught about caring for patients?
How does the author convince you of the truthfulness of his story? Of the patient’s story? What doubts do you have?
What are your reflections on the patient’s biomedical management?
What techniques does the author/doctor use to develop a healing relationship?²^–⁴
How does the resident go about nurturing his professional development through caring for this patient?
What options do you have for similarly fostering your professional development as a healer? ⁵^–⁸
What insights are brought out by the weaving of the threads of patient and physician experience (together and separately) over time?
What other threads do you see woven into this story?
Do you have patients similar to Magdalena in your practice? In what ways have you experienced patients who are similar or different?
Have you ever kept a journal? Have you ever suggested that a patient keep a journal? What effects did you see?
What are some next steps for applying your reflections, questions, and insights in your practice? In your life?

REFERENCES

↵
Stange KC, Miller WL, McLellan LA, et al. Annals Journal Club: it’s time to get RADICAL. Ann Fam Med. 2006;4(3):196–197. http://annfammed.org/cgi/content/full/4/3/196.
OpenUrl FREE Full Text
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Egnew TR. The meaning of healing: transcending suffering. Ann Fam Med. 2005;3(3):255–262.
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Egnew TR. Suffering, meaning, and healing: challenges of contemporary medicine. Ann Fam Med. 2009;7(2):170–175.
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Scott JG, Cohen D, Dicicco-Bloom B, Miller WL, Stange KC, Crabtree BF. Understanding healing relationships in primary care. Ann Fam Med. 2008;6(4):315–322.
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Loxterkamp D. A change will do you good. Ann Fam Med. 2009; 7(3):261–263.
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Kjeldmand D, Holmström I. Balint groups as a means to increase job satisfaction and prevent burnout among general practitioners. Ann Fam Med. 2008;6(2):138–145.
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Gotler, R. Annals Journal Club: Balint groups and ‘the joy of being a doctor.’ Ann Fam Med. 2008;6(2):iii.
↵
Soubhi H, Bayliss EA, Fortin M, et al. Learning and caring in communities of practice: using relationships and collective learning to improve primary care for patients with multimorbidity. Ann Fam Med. 2010;8(2):170–177.
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