Practicing the Art

Does Anyone Have a Case? The Balint Group Experience

By Cecilia Runkle, PhD; Laura Morgan, MD; Eric Lipsitt, MD

The Value

The practice of medicine is often referred to as the "art of medicine." Our experiences in participating in and co-facilitating Balint groups reflect this adage. After a case is presented and clarifying questions answered, the presenter listens while the group verbally shines a light on the case from many perspectives. Gradually, the picture becomes three-dimensional, with many shades and possible meanings. The presenter is then invited back into the group discussion, free to view the picture of their case from new directions. Sometimes, a presenter will put further touches on the picture; sometimes one will paint it over completely; sometimes one will simply contemplate a new picture they'd not been aware of before. In all cases, for all participants, there is a change in perception that leads to finer practice of the art of medicine.

In the community of shared experience, with sensitive and strong facilitation, we learn to support and trust each other. Cases with "risky" content, such as doubt about our medical knowledge, difficulty setting limits, or negative feelings toward patients, become normalized and safe to share and thus better understood. In this community, we heal ourselves while we practice the art of healing others. We believe that Balint groups provide a forum for the kind of professional development that leads to spontaneous personalization of care. We hope to share our enthusiasm and support for initiating this process with all interested colleagues.