Celebrating internal medicine through our human connections with patients – KevinMD.com

Report on Humanistic Patient Care in Internal Medicine and its Alignment with Sustainable Development Goals

Introduction: The Role of Internal Medicine in Achieving Global Health Objectives

An analysis of motivations for pursuing careers in internal medicine reveals a strong emphasis on humanistic patient care, which directly supports the United Nations Sustainable Development Goals (SDGs). The core mission of internal medicine, as championed by organizations like the American College of Physicians (ACP), is to enhance the quality and effectiveness of health care. This aligns fundamentally with SDG 3: Good Health and Well-being, which seeks to ensure healthy lives and promote well-being for all at all ages. The focus on compassionate, patient-centered care is a critical component in achieving universal health coverage and improving health outcomes globally.

Core Competencies and Alignment with SDG 4 (Quality Education)

The training of future internal medicine physicians demonstrates a commitment to a holistic educational model that supports SDG 4: Quality Education. This approach ensures that medical professionals acquire not only technical knowledge but also the skills necessary for effective and compassionate practice. Concerns regarding the interpersonal skills of students from technical backgrounds, such as engineering, have proven unfounded. Evidence indicates these students are equally dedicated to compassionate care, highlighting the success of modern medical curricula in fostering essential soft skills. Key competencies developed in medical training include:

• Advanced diagnostic and problem-solving capabilities.
• Patient-centered communication and active listening.
• Empathy and the ability to form meaningful human connections.
• Advocacy to navigate complex health care systems on behalf of patients.

Case Studies: Patient-Centered Care and its Impact on SDGs

Observational case studies from medical student experiences illustrate the practical application of SDG principles in clinical settings. These instances show how simple acts of connection and advocacy can have a profound impact on patient well-being and health equity.

1. Addressing Mental Health (SDG 3): A student’s engagement with a patient presenting with chest pain revealed the patient was suffering from overwhelming grief following the loss of his wife. By providing a safe space for the patient to share his emotional distress, the student addressed a critical psychosocial component of health, directly contributing to the well-being targets within SDG 3.
2. Reducing Health Inequalities (SDG 10): A student advocated for an uninsured patient with a severe pain disorder. The student’s role as a “detective and advocate” ensured the coordination of specialist care and access to necessary resources during and after hospitalization. This action is a direct contribution to SDG 10: Reduced Inequalities by ensuring access to quality care regardless of socioeconomic status and supports the goal of universal health coverage under SDG 3.
3. Fostering Community and Social Support (SDG 3): During a patient’s multi-week hospitalization, a student helped coordinate an in-hospital celebration and later reconnected with the patient in the community post-discharge. This demonstrates the importance of social support systems in the healing process, a key determinant of long-term health and well-being as outlined in SDG 3.

Institutional Frameworks and Professional Excellence

The mission of professional bodies such as the American College of Physicians contributes to the development of robust health care systems, a cornerstone of SDG 16: Peace, Justice and Strong Institutions. By fostering excellence and professionalism, these institutions ensure that the practice of medicine is effective, accountable, and inclusive. The power of narrative and storytelling is identified as a crucial tool for physicians to advocate for their patients, thereby strengthening the health system’s ability to serve all individuals equitably. The role of such institutions includes:

• Establishing high standards for quality and effectiveness in health care.
• Promoting professionalism and ethical conduct among physicians.
• Supporting the education and development of a medical workforce committed to serving diverse patient populations and advancing global health goals.

Analysis of the Article in Relation to Sustainable Development Goals

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being
   • The entire article is centered on the practice of internal medicine, the quality of patient care, and the well-being of patients. It emphasizes compassionate care that goes beyond treating physical symptoms, as seen in the story of the man with chest pain who was also suffering from “overwhelming grief.” This highlights the connection between physical and mental well-being, a core component of SDG 3.
2. SDG 4: Quality Education
   • The article focuses on the education and training of medical students. It discusses their development not just as diagnosticians but as compassionate caregivers who can connect with patients. The mission of the American College of Physicians, “to enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine,” directly relates to providing high-quality vocational and professional education.
3. SDG 10: Reduced Inequalities
   • The article explicitly addresses inequality in access to healthcare through the story of a student who acted as a “detective and advocate” for a patient with a severe pain disorder. The student’s efforts ensured the patient received appropriate resources “despite their uninsured status,” directly tackling the issue of health disparities based on economic status.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Under SDG 3: Good Health and Well-being
   • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. The article supports the “promote mental health and well-being” aspect of this target by highlighting the importance of listening to patients and addressing their emotional and psychological distress, such as the patient grieving the loss of his wife.
   • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services…for all. The story of the student ensuring an uninsured patient received necessary work-ups, specialist coordination, and resources is a direct example of working towards access to quality healthcare for all, regardless of financial status.
2. Under SDG 4: Quality Education
   • Target 4.4: By 2030, substantially increase the number of youth and adults who have relevant skills, including technical and vocational skills, for employment, decent jobs and entrepreneurship. The article discusses the training of medical students for a career in internal medicine, emphasizing the need for a combination of technical skills (“solving puzzles, the thrill of making a diagnosis”) and crucial soft skills like compassion, listening, and patient advocacy.
3. Under SDG 10: Reduced Inequalities
   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome… The student’s role as an “advocate” for the uninsured patient is a direct action aimed at reducing an inequality of outcome, ensuring that the patient’s lack of insurance did not prevent them from receiving high-quality care and achieving “greatly improved pain and spirits.”

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Implied Indicators for SDG 3 Targets
   • For Target 3.4: Patient-reported outcomes on well-being. The gratitude expressed by the patient who was able to share his grief implies that a measure of progress is whether patients feel heard and emotionally supported, not just physically treated.
   • For Target 3.8: Number of cases where uninsured or underinsured patients receive necessary medical resources and specialist care. The specific anecdote of the student successfully advocating for an uninsured patient serves as a qualitative indicator of progress in providing care regardless of insurance status.
2. Implied Indicators for SDG 4 Targets
   • For Target 4.4: Integration of compassionate care and patient advocacy training into medical school curricula. The article celebrates students who possess these skills, implying that the presence and effectiveness of this training are key indicators of a quality medical education. Patient feedback, like the frequent expressions of gratitude mentioned, could also serve as an indicator of students’ skill development.
3. Implied Indicators for SDG 10 Targets
   • For Target 10.3: Documented instances of patient advocacy leading to equitable health outcomes for vulnerable individuals. The story of the student advocate for the uninsured patient is a prime example. Tracking such interventions and their success would be a way to measure progress in reducing health outcome inequalities.

4. Table of SDGs, Targets, and Indicators

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