Literature DB >> 16960723

[Consultation. Considerations on the practice of medical consultation].

O Leiss1.   

Abstract

On the theme of Linus Geisler's nine steps for a successful consultation between doctor and patient, the ability for self-criticism, the ability to be able to listen to oneself and the value of the doctor-patient relationship in the context of medical practice will be discussed. Subsequently, the framework of the consultation, the consulting room atmosphere and the complete setting of the consultation will be dealt with. The importance of active listening and the recognition of all messages, both verbal and from body language, will be particularly emphasized. The capability for empathy is presented as the necessary bridge to recognition of the feelings and inner world of the patient. Because one only sees what one is looking for and only recognizes what one knows, the recognition of typical complaints presented by patients in a consultation represents the "something" which must be specifically elucidated. The problems and symptoms which the patient brings to the doctor are surrounded by a ring of fears and apprehensions. For this reason it is decisive to uncover the accompanying cloud of fears and apprehensions with appropriate questions, to correctly assign the unsettling symptoms of the patient and to be able to correctly interpret them. As illustrated by the language of nature - the translation of deoxyribonucleic acid (DNA) triplets into amino acids - the translation of biological, psychological and social aspects of the complaints symptomatic into the level of diagnosis and the translation of the referential, social and affective meaning of the expressions used by the patient, into the level of the significance will be discussed. The role of the doctor here is that of a producer of context and a skilled translator. In the management of functional disorders and chronic diseases the construction of a shared reality is important. The therapeutic function of consultations is due to an introduction of metaphors as bridges - bridges to an improved understanding of the body, the self and the world. The role of the physician here is that of a moderator, motivator an accompanying person. Finally, Jaspers levels of good doctoring (natural science or causal level, nursing level, communicative-existential level) are stressed and the importance of a good patient-physician relationship for a patient-centered medicine is underlined.

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Mesh:

Year:  2007        PMID: 16960723     DOI: 10.1007/s00101-006-1070-z

Source DB:  PubMed          Journal:  Anaesthesist        ISSN: 0003-2417            Impact factor:   1.041


  10 in total

1.  Living with Hippocrates in a changing medical world, with particular reference to the patient-physician relationship.

Authors:  J B Kirsner
Journal:  Arch Intern Med       Date:  1992-11

2.  Common symptoms in ambulatory care: incidence, evaluation, therapy, and outcome.

Authors:  K Kroenke; A D Mangelsdorff
Journal:  Am J Med       Date:  1989-03       Impact factor: 4.965

Review 3.  Physician recommendations and patient autonomy: finding a balance between physician power and patient choice.

Authors:  T E Quill; H Brody
Journal:  Ann Intern Med       Date:  1996-11-01       Impact factor: 25.391

4.  Fundamental ethical principles in health care.

Authors:  I E Thompson
Journal:  Br Med J (Clin Res Ed)       Date:  1987-12-05

5.  The irritable bowel syndrome: long-term prognosis and the physician-patient interaction.

Authors:  D M Owens; D K Nelson; N J Talley
Journal:  Ann Intern Med       Date:  1995-01-15       Impact factor: 25.391

6.  Standardized, individualized, interactive, and personalized self-help programs for smoking cessation.

Authors:  J O Prochaska; C C DiClemente; W F Velicer; J S Rossi
Journal:  Health Psychol       Date:  1993-09       Impact factor: 4.267

7.  The clinical application of the biopsychosocial model.

Authors:  G L Engel
Journal:  Am J Psychiatry       Date:  1980-05       Impact factor: 18.112

Review 8.  Diagnosing and treating patients with refractory functional gastrointestinal disorders.

Authors:  D A Drossman
Journal:  Ann Intern Med       Date:  1995-11-01       Impact factor: 25.391

Review 9.  The patient's story: integrating the patient- and physician-centered approaches to interviewing.

Authors:  R C Smith; R B Hoppe
Journal:  Ann Intern Med       Date:  1991-09-15       Impact factor: 25.391

Review 10.  Enriching the doctor-patient relationship by inviting the patient's perspective.

Authors:  T L Delbanco
Journal:  Ann Intern Med       Date:  1992-03-01       Impact factor: 25.391

  10 in total

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