Nathalie Martinek PhD Profile picture
Apr 27, 2018 11 tweets 3 min read Twitter logo Read on Twitter
Some thoughts: There seems to be an assumption in #medicine that patients receive the best care based on best evidence, where evidence usually means quantitative research (my assumption). Yet quality of care is dependent on personal characteristics of each health professional 1/
Knowledge derived from evidence is insufficient to translate into behavioural changes that support the 'best care' intention. Science-based evidence must be channeled through unquantifiable characteristics expressed by each individual health professional to provide best care 2/
These characteristics include: empathy, kindness, unconditional positive regard, non-judgemental attitude, empathic listening, intuition, warmth, encouragement, hope and so on. If we're touting science-based medicine, it must also include practice-based evidence 3/
prof'l wisdom, patient values & ethics otherwise we're sending a message that knowing stuff is more important than demonstrating personal qualities known to support healing/recovery. Empathy, compassion, kindness can't possibly be standardised. People can't be standardised 4/
Patients can't be standardised. All evidence requires good clinical judgement & wisdom to apply to the patient's unique, non-replicable situation. The only way to develop wisdom is through experience + process for evaluating outcomes of decisions/reflection. 5/
Sometimes the information needed to provide 'best care' to the patient comes in the moment through self-awareness, Gestalt or hunch. There's no prior evidence base for it yet it's the most clinically relevant for that patient in that context. CONTEXT matters. 6/
We need to make room for the discoveries that can be made in the moment when it's needed most yet can't be found in journals. Science-based medicine provides the framework for care & its successful implementation depends on the creativity of individual health professionals. 7/
This is what's meant by the Art of Medicine. Art & Science must work together for best care otherwise healthcare will be taken over by robots who lack the power of human touch.
We must get over our addiction to needing certainty, when uncertainty & change are constants. 8/
It's time to put as much value in research dedicated to exploring and understanding the art of medicine to understand how our personal qualities/characteristics + unbiased research evidence promote healing, wellness, building capacity, confidence & thriving through life too. 9/
If wellness is the goal, we need to focus on generating evidence of wellness in patients & influence in alleviating symptoms of illness instead of only studying illness aiming to decrease it. Focus on what we want in order to see more of it or we remain stuck in the problem. 10/
In summary: science-based evidence + practice-based evidence + patient values &characteristics + professional wisdom + ethics + professional characteristics/qualities/skills + context = best practice. It ain't easy. Let's take it easy on each other. @MasterUrWords #medtwittter

• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with Nathalie Martinek PhD

Nathalie Martinek PhD Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @NatsforDocs

May 24, 2018
I mentor & coach physicians on their wellbeing & how to use their energy wisely.

Just as there are people called to work in healthcare, it's my calling to serve those who help people in their most vulnerable times & phases of life to continually have the capacity to do it.
Somewhere along the journey to becoming a physician, students started believing that they should be able to handle everything they're exposed to & developed messy coping habits that impact on their ability to connect with others & self in healthy ways.
Healers need healers otherwise they will fail to recognise how their own suffering can become a source of wisdom to apply in their work with patients & in supporting their peers/colleagues. Instead, personal suffering or denial of it, can take one's mind into dark places.
Read 10 tweets
May 15, 2018

Being an entrepreneur comes with a sense of freedom & none of the institutional limits on creativity. Yet unless I'm consulting within an organisation or connected to community, it can feel lonely & isolating. Online communities are great for support but it's not enough.
I've seen the negative effects of people investing all their time/energy in networking online & draining group dynamics. I realised that one of my values is to participate in collaborations that involve physical meet ups or at least in the potential of physical meetups. 2/
What can I say? I derive inspiration from in person experiences. So it's not surprising that I notice changes in my thinking patterns & emotional landscape when my interactions are more virtual than physical. It's de-motivating & raises mental health alarm bells 3/
Read 20 tweets
May 11, 2018
The end of my week involves reflecting on my week and what I've learned from my experiences & conversations with others. Topics in my awareness are gender inequality in medicine, physician burnout, abuse in healthcare & sharing/oversharing our stories 1/
There are those here who strive to inspire peers, provide a space for connection & rally for change through the various discussion threads. It's clear to me that there's a lot of passion & desire to do great things in the world by those who I follow/see in my feed. 2/
I can also feel the collective frustration/anger/angst/sadness/resignation/sympathy/name that heavy emotion when any of our efforts aimed at success & liberation from system constraints appear to be blocked by injustice, abuse, ineffective strategy or poor communication. 3/
Read 17 tweets
May 8, 2018
This is my commentary on #twitter #movements. Before I go I want to preface this with a statement: I love humans. We're amazing creative & powerful beings. I'm fascinated by human behaviour and the hidden motivations underlying our basic need to belong. 1/
I've observed some movements taking off on Twitter. Some for #MedEd, raising awareness, knowledge sharing, inspiration and sharing failings, wounds & triumphs. Generally they support creative expression in 280 characters. Awesome! 2/
As these movements gain momentum, more people want to join in b/c #belonging. I'm seeing a disturbing trend of sharing experiences of patients/clients to promote how deep & human they are. Some are purely intended, some not. 3/
Read 21 tweets
May 1, 2018
I’m going to pitch in here. A lot of what’s considered burnout is actually compassion fatigue. Poor understanding of either which affects types of interventions, prevention & support available. Let’s also remember how boys are socialised to be ‘men’.
Depersonalisation: shut down of empathy to cope. Emotional exhaustion: too much empathy & absorbing emotional burden + vicarious trauma thrown in. Both contribute to compassion fatigue-looks like burnout but isn’t.
Burnout is related to untenable/unsustainable work conditions rather than emotional labour. Burnout is the signal that your ideal life doesn’t match your reality & you’re working hard to maintain what you have rather than make choices that move toward ideal. Energy sucking life.
Read 9 tweets
Apr 18, 2018
Wellbeing preservation in healthcare (within your control)

1. Stable & trusting connections to others
2. Connection to self - meditation, self-reflection, self-examination ie. quiet time
3. Connection to your environment/Nature

#medtwitter #phdchat #MH4Docs #womeninmedicine
4. Connection to your purpose (your Why) & desire to serve wellbeing of others
5. Peer support & group reflective practice w/ agreements to preserve confidentiality, respect, non-judgement & openness
6. Mentoring by someone who has qualities you want/admire & skills you need

7. Therapy with someone who can see in you what you can’t ie. your strengths, growing edges & blind spots)
8. Have a life & interests outside of your profession
9. Trust your intuition by listening to it and following through. If something feels ‘off’ it is.

Read 5 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!


0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy


3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!