Humor_in_medicine

Gold Humanism Honor Societypresents

Gold Nuggets

Gold Humanism Honor Society

• Recognize, support and promote values of humanism and professionalism in medicine

• Work within and beyond medical education to inspire, nurture and sustain lifelong advocates and activists for patient-centered medical care

Humor In Medicine: Can We Laugh and Still Be “Doctors”

I Remember When…

Then Life Ended…

Hello 3rd Year!

Humor’s Role in Medicine

• Humor and Health• Humor and Patient-Physician

Communication• Humor and the Health Professional• Humor in Medical Education

Humor and Health• NORMAN COUSINS, “ANATOMY OF AN ILLNESS”

– Treated ankylosing spondylitis with “laughter and Vitamin C”

– “10 minutes of laughter resulted in 2 hours of pain-free sleep and a drop in his ESR” 1

• IMMUNE BENEFITS OF HUMOR– Decreases immunosuppressive effects of stress 2

– Decreases cytokines in rheumatoid arthritis pts. 3

• LAUGHTER AND PAIN– Pain tolerance enhanced, need for pain meds

decreased after exposure to funny movies 4

1Cousins, N. Anatomy of an illness (as perceived by the patient). N Engl J Med. 1976;295:1458-14632Martin, RA, Dobbin, JP. Sense of humor, hassles, and immunoglobulin A: Evidence for a stress-moderating effect of humor. Int J Psychiatry Med. 1988;18:93-105.3Yoshino S et al. Effects of mirthful laughter on neuroendocrine and immune systems in patients with rheumatoid arthritis. J Rheumatol. 1996;23:793-794.4Cogan R et al. Effects of laughter and relaxation on discomfort thresholds. J Behav Med 1987;10:139-144.

Humor and Patient-Physician Communication

• BUILDING RELATIONSHIPS THROUGH HUMOR– Relieves anxiety, communicates caring, narrows

interpersonal gaps, provides an acceptable outlet for anger and frustration 5

– Differs on a case-by-case basis

• IMPROVING PATIENT SATISFACTION– Satisfaction scores increased when physicians spend a

few extra minutes with patients, make a connection 6

• HUMOR AND MALPRACTICE– Physicians with no history of malpractice found to:

1. Spend more time with patients2. Use facilitative statements more often3. Relied on humor and laughter more during their patient encounters

75Wender, RC. Humor in medicine. Prim Care. 1996;23:141-1546Gross et al. Patient satisfaction with time spent with their physician. J Fam Pract. 1998;47:133-1377Levinson et al. Physician-patient communications: the relationship with malpractice claims among primary are physicians and surgeons. JAMA 1997;277:553-559.

Humor and the Health Professional

• PREVENTING BURNOUT– Doctors with best coping skills find humor

in situations, have highest level of job satisfaction 8

– ER, ICU, Oncology physicians, residents most frequently studied

• GALLOWS HUMOR– Freudian theory – morbid humor in the

face of tragedy or death 9

– Dangerous opportunity for misinterpretation

8Keller et al. Management of stress and prevention of burnout in emergency physicians. Ann Emerg Med 1989;18:42-47.9Freud S. Jokes and their relationship to the unconscious. New York, W.W. Norton, 1960, pp 229-230.

Humor in Medical Education

• HUMOR IN THE CLASSROOM– Professors who incorporate humor into

presentations receive higher student ratings 10

– Comical, enthusiastic style positively affects student test performance immediately after lecture 11

– In a 14-week college statistics course, students who were exposed to humor performed significantly better than the group not exposed 12

10Naftulin et al. The Doctor Fox lecture: A paradigm of educational seduction. J Med Educ 1973;48:630-635.11Ware et al. The Dr. Fox effect: A study of lecturer effectiveness and ratings of instruction. J Med Educ 1975;5:149-156.12Ziv, A. Teaching and learning with humor: Experiment and replication. J Exp Educ 1988;57:5-15.

Summary• Humor has both physiologic

and psychological benefits on health

• Laughter can be a key element in establishing rapport with your patients and building long-term relationships

• Humor provides a critical release for the most stressful of situations, but has the power to be extremely hurtful when taken out of context

• Students of all ages and experience levels can benefit positively from the use of humor in their curriculum

Happy Holidays!