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Professional Medical Discourse and the Emergence of Practical Wisdom in Everyday Practices: Analysis of a Keyhole Case

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Abstract

Recent publications have argued that practical wisdom is increasingly important for medical practices, particularly in complex contexts, to stay focused on giving good care in a moral sense to each individual patient. Our empirical investigation into an ordinary medical practice was aimed at exploring whether the practice would reveal practical wisdom, or, instead, adherence to conventional frames such as guidelines, routines and the dominant professional discourse. We performed a thematic analysis both of the medical files of a complex patient and her daughter’s diary. We did find practical wisdom, but only sporadically, whereas it has proved to be essential for professional care. This deficit appeared to result from several factors like: the organization of the practice; established routines; a hierarchical culture; and a traditional medical discourse. Moreover, we discerned various negative consequences. More empirical research into practical wisdom in everyday medical practices is needed for the benefit of professional and morally good care for every patient.

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Authors and Affiliations

  1. Pediatric Department, St Jansdal Hospital, Harderwijk, The Netherlands

    Marij Bontemps-Hommen

  2. North-West University, Vanderbijlpark, South Africa

    Andries Baart

  3. University Medical Center, Utrecht, The Netherlands

    Andries Baart

  4. University of Humanistic Studies, Utrecht, The Netherlands

    Frans Vosman

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  1. Marij Bontemps-Hommen
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  2. Andries Baart
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Correspondence to Marij Bontemps-Hommen.

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Bontemps-Hommen, M., Baart, A. & Vosman, F. Professional Medical Discourse and the Emergence of Practical Wisdom in Everyday Practices: Analysis of a Keyhole Case. Health Care Anal 28, 137–157 (2020). https://doi.org/10.1007/s10728-019-00385-7

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