Three stages of medical dialogue

Author(s): Schwartz, E.

Journal/Book: Theor Med. 1996; 17: Spuiboulevard 50, PO Box 17, 3300 AA Dordrecht, Netherlands. Kluwer Academic Publ. 175-187.

Abstract: The negative consequences of physicians' failure to establish and maintain personal relationships with patients are at the heart of the ''humanistic crisis'' in medicine. To resolve this crisis, a new model of doctor-patient interaction is proposed, based on the ideas of Martin Buber's philosophy of dialogue. This model shows how the physican may successfully combine the personal (I-Thou) and impersonal (I-It) aspects of medicine in three stages. These ''Three Stages of Medical Dialogue'' include: 1. An Initial Personal Meeting stage, which initiates the doctor-patient relationship and involves mutual confirmation; 2. An Examination stage, which requires a shift from a personal to an impersonal style of interaction; 3. An Integration Through Dialogue or ''Healing Through Meeting'' Stage, which involves the integration of the impersonal medical data into the ongoing dialogue between doctor and patient, as a basis for shared decision-making. The use of the model, as well as common failures of doctor-patient dialogue are discussed.

Note: Article H Abramovitch, Tel Aviv Univ, Sackler Sch Med, Dept Internal Med, Dept Behav Sci, Ramat Aviv, Israel

Keyword(s): communication; compliance; doctor-patient relationship; medical dialogue; medical education; philosophy of medicine; satisfaction; DOCTOR-PATIENT COMMUNICATION; PHYSICIAN BEHAVIOR; SATISFACTION; PRACTITIONERS; INFORMATION; ANXIETY

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