title: [Physician consultation: a main medical factor].
abstract: The patient's rating remains largely uninfluenced by the physician's quality as such--it is mostly the quality of the interpersonal contact, which counts, along with banal circumstances, such as the daily menu. It is conversation with the patient, which ought to be re-discovered as an important medical function, particularly in view of trends for medicine to become increasingly technical and specialised. This holds true for clinical routine as well as for medical education and training. We envisage an organic and systematic development from primary contact with the patient (including non-verbal and behavioural aspects) and spontaneous conversation towards basic psychotherapy. All medical and nursing staff ought to be included in this approach. Thereby the ground would be prepared for special psychotherapeutic techniques which might be applied later (not discussed here). A rather critical item is instruction at the patient's bedside, which we continue to regard as necessary, but which requires observation of special rules and enhanced attention, in order not to have detrimental effects. Also highly important are well-controlled contacts with the relatives of the patient. While these factors tend to be regarded as incidental, they have the potential for becoming rather important: By way of the emotional condition they can become relevant for healing and rehabilitation. Since neither medical routine nor education and training do currently pay enough attention to them, it is indicated to point this out more regularly.
authors.affiliation: Ludwig-Boltzmann-Institut für Neuro-Rehabilitation und -Prophylaxe, Vorarlberger Landes-Nervenkrankenhauses Valduna, Rankweil.
authors.forename: G S
authors.initials: GS
authors.lastname: Barolin
mesh_terms: D001317:Austria; D003479:Curriculum; D004501:Education, Medical; D006801:Humans; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011613:Psychotherapy / Q000193:education; D012017:Referral and Consultation
vernacular_title: Das ärztliche Gespräch: ein medizinischer Hauptfaktor.