• K Laemmel.
• Psychiatrische Klinik, Kantonsspital Luzern.
• Praxis (Bern 1994). 1996 Jul 2; 85 (27-28): 863-9.

AbstractThe very earliest myths relating to the art of healing give great weight to the vital importance of human dialogue. Today's technology, however, supplies the physician with so many diagnostic and therapeutic tools that the one-on-one encounter with the patient is steadily losing its significance. And yet, even today the dialogue is still one of the most important components of the healing process. The dialogue between physician and patient has three generally acknowledged objectives: gaining information about the illness, getting a clear understanding of the patient as a person, and the therapeutic effect. Taking the patient's history largely serves the first objective. At this stage, the physician--depending on his orientation--already chooses from a wide spectrum of approaches: from conducting a cursory, purpose-oriented interview to engaging in an open compassionate dialogue. The last approach, anchored in a spirit attuned to the patient's psyche and mind-set, will not only yield important clues as to the systemic interrelationships underlying the disease, but it also provides the foundation for the therapeutic dimension of the dialogue. By engaging in a dialogue and by his very readiness to do so, the physician unconsciously reveals a lot about his own person. In order to achieve a true dialogue, it is necessary that he abandon the role-playing so common to physician-patient relationships and that he meet his patient on a person-to-person basis. In the process he will reveal his self-perception, his relationship to fellow human beings and, not least, his idea of what it means to be a healer. This idea depends completely on his perception of human beings in general, on whether he sees people as complex machines controlled by the brain computer or as spiritual beings whose bodies function as the screen onto which their thoughts, ideas and convictions are projected. A true dialogue between physician and patient provides the foundation for healing to take place. The complete trust of the patient, his willingness to cooperate, his compliance, and, in the end, the very healing process itself depend on the physician's ability to engage in dialogue. The art of meaningful communication can be taught. Medical students, the physicians-to-be, can learn a lot from the example set by their mentors. When university professors, chiefs of service and supervising attending physicians are appointed, their ability to demonstrate not only a gift of dialogue, but also the awareness of its vital importance in a doctor-physician relationship should be a decisive factor.

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