Mutual patient-psychiatrist communication and the therapeutic contract.

The increasing complexity and subspecialization of medicine make the patient feel lost in the anonymity and strange complexity of modern hospitals, lead to a misunderstanding of the increasing risks and impact of modern treatments, and restrict personal communication due to the prevalence of a knowledge-oriented approach, to a shortage of time, and to insufficient communication skills. All of this may cause increasing dissatisfaction and complaints of patients. Therefore, it is a future task (1) to develop a concept of medicine and psychiatry well-balanced for science-based knowledge and the value-based art of communication, (2) to change the framework of communication in medical and psychiatric practice, and (3) to improve the training of physicians in communication skills in order to fulfill the therapeutic contract successfully.