The Issue of Communication within Medicine

Abstract

Communicating is one of the physician's most important skills; yet there are serious impediments to acquiring such assets in medical curricula as customarily presented. Balint attempted to fill a void in this significant area through an innovative approach to group discussion of cases, which enabled the doctor to “use himself” more effectively in the doctor-patient relationship. Through self-development and insight, the physician could improve his “apostolic function” as a teacher-to the patient's benefit. Communication is viewed as a two-way exchange, acknowledging the impact of the doctor upon the patient as well as the patient upon the doctor. The “soft” data of experience, behavior, dress and speech are as relevant as more quantifiable information. The ambiguity of words-and even silence-can have a profound influence upon illness in the context of the interaction between patient and physician. In spite of the difficulties of evaluating studies in the area of human relations, medical students and physicians are urged to undertake such explorations to enhance their own growth and perceptiveness and thereby improve their capacity to communicate meaningfully. Representative examples of such studies–including the small-group experience as used by Balint-are reported.