[The physician as an agent of change and the change in the outlook of the physician].
Illness implies, to a lesser or greater extent, a "vital crisis", and it is sometimes the only visible part of the maelstrom. The medical conception of illness, based on cut out nosological entities with specific organic or mental locus, splits the patient's reality. Such an approach fosters and spreads illness, since it leads the dynamic field of doctor-patient relationship to stagnation. The example is given of a case treated by a member of a (modified) Balint group, an endocrinologist who sees the patient after many derivations, and focuses the therapy on the one symptom his speciality enables him to deal with most proficiently: excess overweight. Such an approach was unfit to grasp the whole of the patient's behaviour and protheic symptoms. The group points to the need for a change to a wider and more comprehensive approach. The practitioner understands such a need, which implies also a change in his own previous technical patterns; he now views himself as the "organizer" of the patient's situation, and succeeds in integrating a comprehensive conception of the total illness. This change involves more than just a technical switch; a slight apparent variation, implying deep changes in the doctor's personality is achieved the way Balint encourages which in turn modify the whole ideology at the basis of conceptions of illness and of being-ill. We hold that illness doesn't have either a "natural history" or a unique determinant, but that different medical conceptions and ideologies are at the basis of many different ways of evolving and developing the situation of "being ill".
D000328:Adult; D006801:Humans; D008297:Male; D009765:Obesity; D010817:Physician-Patient Relations; D011586:Psychology, Clinical
El médico como agente de cambio y el cambio en las perspectivas médicas