What Is the Presence Medicine Approach?

The Presence Medicine Approach is a model of physician care for patients with aphasia, created by Dr. Jenelle Jindal. It is centered on sustained, unhurried physician attention as the primary resource in the clinical encounter.

Standard medical appointments are typically 15 minutes long. Research shows that physicians interrupt patients within 11 seconds on average. For people with aphasia -- who need more time, more patience, and different modes of communication -- these constraints create a structural barrier to care.

The Presence Medicine Approach addresses this barrier. It is rooted in the medical humanities tradition of narrative medicine and informed by the social model of disability, which recognizes that disability arises not from the individual alone but from the interaction between the person and an environment that fails to accommodate their needs.

Core Principles

1. Time as the Primary Resource

Extended physician encounters are designed around the patient's communication needs, not institutional scheduling constraints. Time is a form of communication accessibility. When a person with aphasia is given the time they need, they can participate more fully in their own care.

2. Communication Accessibility

The clinical environment is adapted to support people with aphasia. This includes multimodal communication -- spoken, written, and gestural -- with no interruption and patient-controlled pacing. The goal is to remove communication barriers, not to change the patient.

3. Physician as Witness

Grounded in Rita Charon's narrative medicine framework, the physician's role is to be fully present, to listen deeply, and to witness the patient's experience. Sustained physician presence during recovery honors the full scope of what a person with aphasia goes through -- not just the medical facts, but the human experience of living with a communication disability.

4. Patient-Driven Recovery

The physician creates conditions that support recovery. The patient is the active agent. Recovery goals are defined by the person with aphasia, reflecting what matters most to them in their life. The physician does not perform interventions on the patient.

5. Supplemental Care

The Presence Medicine Approach is complementary to existing neurological care, speech-language pathology, and primary care. Patients maintain their existing medical relationships. This approach provides focused physician attention as an additional layer of support.

6. Life Participation Approach to Aphasia (LPAA)

Philosophically aligned with the Life Participation Approach to Aphasia, the goal is full participation in meaningful life activities -- not test scores or clinical metrics alone. The measure of progress is the person's ability to engage in the life they want to live.

Important Clarifications

The Presence Medicine Approach is a model of physician care. It is not a replacement for any existing care. It is not an intervention, procedure, or protocol. The physician listens, is present, and witnesses within an environment that supports recovery.

This approach is currently in development. Jindal Neurology, Inc. is not currently seeing patients for the Presence Medicine Approach or any other clinical service.

Jindal Neurology, Inc. is available to sign nondisclosure agreements (NDAs) to protect patient and family privacy.

Jindal Neurology, Inc. is not currently accepting new patients. Please check back for future updates on availability.