Arts and Poetry in the Clinic: A Novel Approach to Enhancing Patient Care and Job Satisfaction

THE INNOVATION

Working in a federally qualified health center (FQHC) presents many challenges including limited time to develop a deep understanding of patients’ complex health issues and psychosocial needs. The frustration from both physicians and patients stimulated us to think creatively. We incorporated arts and poetry into our practice to improve patient experience; help clinicians and patients work together more effectively towards common goals¹; and improve job satisfaction for physicians and staff. Most primary care practices face patient and staff frustrations. Regardless of differences in settings, they can benefit from including the arts because of a shared commitment to holistic, patient-centered care.

WHO & WHERE

The physician author, the project leader, provided short training sessions in the uses of art and literature to other clinicians and medical assistants who work directly with patients at the University of California, Irvine’s FQHC in Anaheim, California. Best practices continue to be passed on to all clinicians interested in carrying out arts-based activities.

HOW

To improve difficult clinical encounters and address clinicians’ desires to improve the clinic experience, we introduced several arts-based interventions.

Some of the most meaningful and beneficial activities include times when we invite patients to tell their stories through art, poetry, and music. Few patients decline to participate, and we make it clear that opting out of drawing or reading poetry will not negatively affect their care.

When we present patients with a blank sheet of paper and ask them to draw themselves and how they see their health, amazing stories leap from the page. Whenever possible, we discuss these with the patient as soon as they are completed. Many of the drawings help us see the patients as they want to be seen and how they want their medical condition to fit into their overall lives. Regardless of race, gender, language, and socioeconomic status, patients who value holistic care find these activities valuable.

Clinic physicians have used these interventions most often in chronic disease visits with a focus on uncontrolled health issues. They also fit well in annual wellness visits. Currently, patient artwork is not included in the electronic medical record but kept in a separate file.

Sharing poems with patients gives them an opportunity to express submerged emotions that are often directly relevant to their care. Other times, when we show patients a painting, we are able to gain valuable insights into how they interpret the world and how they approach problem solving, both of which help personalize treatment plans. (Supplemental Appendix)

Use of arts-based materials also benefits clinic staff. When needed, we comfort a distressed staff member by playing the relaxing sounds of ocean waves or raindrops on an iPad to give them a 5-minute respite.

LEARNING

Patients and clinicians benefit from exposure to a poem, drawing, or other art forms. Anecdotal feedback suggests that inclusion of arts-based activities in the clinic makes patients feel welcomed and at home, while clinicians and staff experience greater job satisfaction. Sharing a poem or looking at a patient’s self portrait stimulates compassion, insight, and understanding with patients previously seen only as challenging.

Having a physical and electronic collection of materials facilitates choosing the appropriate arts-based modality. Flexibility and creativity are key to making a visit memorable and meaningful for all.