title: Three stages of medical dialogue.
abstract: The negative consequences of physicians' failure to establish and maintain personal relationships with patients are at the heart of the "humanistic crisis" in medicine. To resolve this crisis, a new model of doctor-patient interaction is proposed, based on the ideas of Martin Buber's philosophy of dialogue. This model shows how the physician may successfully combine the personal (I-Thou) and impersonal (I-It) aspects of medicine in three stages. These "Three Stages of Medical Dialogue" include: 1. An Initial Personal Meeting stage, which initiates the doctor-patient relationship and involves mutual confirmation; 2. An Examination stage, which requires a shift from a personal to an impersonal style of interaction; 3. An Integration Through Dialogue or "Healing Through Meeting" Stage, which involves the integration of the impersonal medical data into the ongoing dialogue between doctor and patient, as a basis for shared decision-making. The use of the model, as well as common failures of doctor-patient dialogue are discussed.
authors.affiliation: Dept. of Behavioral Science, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: H
authors.initials: H
authors.lastname: Abramovitch
authors.forename: E
authors.initials: E
authors.lastname: Schwartz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003657:Decision Making; D005260:Female; D006808:Humanism; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010686:Philosophy, Medical; D010817:Physician-Patient Relations; D011582:Psychological Theory; D035502:Trust