Modern medicine and healthcare systems are in crisis. In the last decades, medicine has gained deep, scientific insights into the biological basis of health and disease, and while htis has led to many successes, it has brough about a dramatic change of medical focus. In this new translation, Bruno Kissling and Peter Ryser offer a solution – and show how a person-centred medical consultation might overcome this crisis of modern medicine.
What is Person-Centered Medicine?
It is our understanding that in all of medicine – and not just in general practice – the goal is to put patients with their symptoms and problems, their view of reality based on their life context, their abilities, resources, and needs at the centre of every diagnostic and therapeutic effort. This approach is also true for non-medical activities, executed in any healthcare environment (such as counselling).
This understanding of person-centred consultation demands a workable and trustful relationship between the patient and the doctor. How the physician ‘treats’ a patient should be defined by respect, empathy, and authenticity – these are the essential elements of therapeutic efficiency.
The Consultation as an Encounter Between Patient and Doctor with its own Therapeutic Potential
At the centre of everything lies the consultation: that is where the patient and the doctor meet, where together they design and nurture their relationship. That is where they transform the patient’s symptom(s) into a shared reality and develop a common ‘assessment’ (diagnosis). That is where they discuss the medical-technical and/or psychosocial therapeutic alternatives and adapt them to the personal needs of the patient. That is where they jointly arrive at a consensus and agree on a solid and constructive path toward achieving the anticipated solution.
A methodologically soundly structured consultation provides both the patient and the doctor with clear orientation. It sharpens their respective attention to the background of the symptom(s) and interactions thereof in real life. It also helps them to better judge the overall situation. And, finally, it enables them to include complex circumstances and resources in the process of diagnosis and therapy. A proper consultation brings out the best possible qualities in both patient and doctor in the respective situation.
Active listening, summarizing the conversation, inquiring about unclear matters on both an objective and emotional level as well as formulating poignant questions help physicians to keep themselves and their patients properly oriented. By reflecting on the patient’s symptom(s) and their meaning, the physician directs their attention to existing resources and expectations and reframes the situation by providing an enhanced view. Largely unbeknownst to both parties, this turns the consultation into a powerful instrument with its very own therapeutic potential.