Issue link: https://www.massageandbodyworkdigital.com/i/1338685
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 43 In the US, the more commonly used word for a person seeking treatment in the MT context is usuallyªclient. In this series of articles,ªI have deliberately chosen to use the more traditionalªpatientª(meaning somebody enduring an illness) or the more neutralªperson, to reflect how our choice of words is crucial to shifting our thinking about the therapeutic relationship. More could be said on whether the passivity of "patient" is itself due for a rethink, but that is for another time. Therefore,ªclientªis only used when I am directly specifying the transactional relationship involving monetary payment. what some are calling an "identity crisis" in MT professions, which may face an uncertain future 1 in which some institutions are debating whether to even teach hands- on skills, 2 and broad discussions are taking place regarding whether these techniques should be used at all. Meanwhile, a quiet revolution is taking place in the biomedical disciplines at the very highest levels. The questions of how to implement the BPS approach, how much to "educate" the patient, and how to develop treatment plans have been flipped on their head by allowing patients to guide the process—with clinicians in the role of facilitators rather than all-knowing saviors. Particularly in the context of primary care (but also at secondary and tertiary levels), an understanding of the limitations of rigid evidence-based medicine (EBM) policies has set in, as well as of certain misinterpretations, misapplications, and shortcomings of the BPS model. This biomedical discipline revolution hinges on the medical humanities—an interdisciplinary field looking to embed humanities-based knowledge and skills within medical practice with the aim of better serving patients—by once again treating them as "whole humans," rather than simply ailing bodies. Buzzwords such as person-centered, empathy, mindfulness, and emotional intelligence have been crowding the airwaves for years, with the ultimate goal of acting as a counterweight to the often cold, impersonal, and reductionist biomedical approach. In terms of application and outcomes, though, there has been little to actually show for "the revolution" beyond theoretical self-improvement and a checkbox approach that may pay lip service to BPS principles but does not necessarily have the desired impact on the patient. Plug the word biopsychosocial into a research database and dozens of articles appear. The majority of these articles concern physician perception of the efficacy of the approach and qualitative outcome measures. A significant number also query its applicability in the context of patient quotas and limited resources. Few, however, deal with the patient's side of the story. The keyword here is humanity. The BPS model, as I explore in the next article in this series, has gone a long way toward shifting attitudes regarding the therapeutic relationship, but not far enough. The ultimate aim is still to "reeducate" the patient from a position of authority by imposing one's opinion on the patient In this four-part series, the background, potential, and practicalities of narrative medicine will be explored. I will focus on its relevance and applicability to the manual therapy professions in particular. In this first article, I explain the context of medicine's "identity crisis," review earlier developments in medicine, and offer an understanding of how the medical revolution affects MTs. In Part 2, I summarize the principles of narrative medicine in comparison to evidence-based medicine (EBM) and the biopsychosocial (BPS) model. I also highlight issues that emerge. Part 3 will examine a case study and offer exercises to demonstrate the application of the methods described in an MT context. Finally, Part 4 will consist of a more detailed critical appraisal of narrative medicine and its companion, graphic medicine, with attention to their potential for implementation in the MT professions in general, and massage therapy in particular. Beyond the potential benefit to individual practice, in view of the current restrictions due to the COVID-19 pandemic, this information may provide a valuable path of exploration and training for MTs who are looking for ways to pivot professionally. The information may also be a valuable way to bridge EBM practice with current developments.