[Nonsymmetrical communication in clinical visits (author's transl)].

The article tries to demonstrate on an empirical basis how physicians in hospitals react to threatening situations, namely the demand of information about illness by severely ill patients. Four types of reaction relating to physicians' verbal communications are distinguished and illustrated by tape-recordings on clinical visits:1. Disregard, 2. Shift of the topic or the addressee, 3. Communication of "reference-information", 4. Communication of "functional uncertainty". The results demonstrate that nonsymmetrical communications are significantly more usual in regard to severely ill than regard to non severe patients and significantly more usual among traditionally trained physicians than among physicians with psychosomatic or psychotherapeutic training or orientation. Some practical consequences are mentioned, especially in the field of medical education.