Everyday Diabetes recently had the chance to chat with Dr. Masatake Sugimoto from the Tokyo Adventist Hospital in Japan. Dr. Sugimoto is a proponent of the patient-centered “Narrative Approach”, a method whereby the practitioner is interested in the stories that shape peoples lives.
During a recent presentation at the ICDM diabetes conference in Korea, Dr. Sugimoto summed up the approach as “respecting the patient as the main character of their story” and “respecting that their story is unique.” Dr. Sugimoto added that “we try to listen to the story of their disease as a story of their life.”
Here is one of the slides from his presentation that illustrates the approach quite well.
Can you tell us about your area of study and what you are currently working on?
Ever since being introduced to the Narrative Approach, I have been exploring ways to implement it when treating patients with diabetes. The Narrative Approach is a practice based on social constructionism and has a background in many areas such as anthropology, clinical psychology, clinical sociology, and philosophy.
In my particular case, I am most strongly influenced by medical anthropology. The Narrative Approach emphasizes the use of “stories” as a means of understanding human beings, and focuses on understanding the “meaning” behind human acts.
What are ways that physicians can bring these methods into their treatment of diabetics?
First, in order to teach medical students the concepts of Illness, Narrative Competence, Cultural Competence, etc. it is necessary to incorporate medical anthropology into the medical school curriculum.
Second, I would like to explain the self-imposed training that I imposed upon myself when I started exploring the Narrative Approach. Sometimes there are patients who make complaints and very difficult demands at outpatient clinics every day. After returning home, I would recall the conversations with such patients, and record them as much as possible on my computer.
I would also think about why they were unhappy about their situation, what exactly the patient wanted from me, and what kinds of words and language I should have used in my response. It was a diary I could use for self-reflection. I found this training to be very effective.
Third, I have done a practical study involving patients writing down their own experience and stories about their diabetes and conduct team conferences with them as subjects. Sharing these patient stories with teams may be a driving force for patient-centered medical care.