Publicatie
Publicatie datum
Communication in medical encounters.
Bensing, J.M., Verhaak, P.F.M. Communication in medical encounters. In: A. Kaptein; J. Weinman. Health psychology. Malden; Oxford; Victoria: British Psychological Society; Blackwell Publishing, 2004. 261-287
The aim of this chapter is to provide a theoretical and empirical basis for the concept of
communication as the core instrument in the medical encounter. Adequate communication, embedded in a
warm and caring relationship, has always been recognized as essential to the concept of good
doctoring, but for long periods of time this was considered as 'the art of medicine', distinguished
and distinguishable from medical science. In the last decades empirical research has helped to turn
art into science. We will summarize the evidence, focusing on ' the placebo effect'. We will them
show that at about the same time that we began to understand the dynamics of the medical encounter,
the doctor-patient relationship itself was subject to major changes. Changes in patient morbidity,
in the power balance between doctors en patients, and in the amount and availability of medical
information for laymen have had profound influences on the doctor-patient relationship. These
societal changes have fed and are fed by a paradigm shift in medicine: from supply-induced care to
demand-induced care, from doctorcentred medicine to patient-centred medicine, from clinical
decisions to shared decision-making. Each of these developments demand a revaluation of
communication as a relevant tool in medicine. The doctor-patient relationship in the context within
which patients' expectations and beliefs are shaped and management decisions are taken. This
relationship is changing over time and between cultures as well. Patient groups and individual
patients may have a variety of needs, expectations and preferences, which require tailored
communication by physicians. As a consequence, teaching general communication skills in medical
education is not sufficient anymore. Moreover, the shift from doctor-centred to patient-centred
medicine also implies a shift in focus from at the physician's to the patients's role in medical
encounters, with explicit attention to patients' illness representations and self-regulation in
disease management. By applying principles from health psychology, the medical encounter changes
from 'powerful placebo' into a place for 'empowering patients'. (aut ref.)
communication as the core instrument in the medical encounter. Adequate communication, embedded in a
warm and caring relationship, has always been recognized as essential to the concept of good
doctoring, but for long periods of time this was considered as 'the art of medicine', distinguished
and distinguishable from medical science. In the last decades empirical research has helped to turn
art into science. We will summarize the evidence, focusing on ' the placebo effect'. We will them
show that at about the same time that we began to understand the dynamics of the medical encounter,
the doctor-patient relationship itself was subject to major changes. Changes in patient morbidity,
in the power balance between doctors en patients, and in the amount and availability of medical
information for laymen have had profound influences on the doctor-patient relationship. These
societal changes have fed and are fed by a paradigm shift in medicine: from supply-induced care to
demand-induced care, from doctorcentred medicine to patient-centred medicine, from clinical
decisions to shared decision-making. Each of these developments demand a revaluation of
communication as a relevant tool in medicine. The doctor-patient relationship in the context within
which patients' expectations and beliefs are shaped and management decisions are taken. This
relationship is changing over time and between cultures as well. Patient groups and individual
patients may have a variety of needs, expectations and preferences, which require tailored
communication by physicians. As a consequence, teaching general communication skills in medical
education is not sufficient anymore. Moreover, the shift from doctor-centred to patient-centred
medicine also implies a shift in focus from at the physician's to the patients's role in medical
encounters, with explicit attention to patients' illness representations and self-regulation in
disease management. By applying principles from health psychology, the medical encounter changes
from 'powerful placebo' into a place for 'empowering patients'. (aut ref.)
The aim of this chapter is to provide a theoretical and empirical basis for the concept of
communication as the core instrument in the medical encounter. Adequate communication, embedded in a
warm and caring relationship, has always been recognized as essential to the concept of good
doctoring, but for long periods of time this was considered as 'the art of medicine', distinguished
and distinguishable from medical science. In the last decades empirical research has helped to turn
art into science. We will summarize the evidence, focusing on ' the placebo effect'. We will them
show that at about the same time that we began to understand the dynamics of the medical encounter,
the doctor-patient relationship itself was subject to major changes. Changes in patient morbidity,
in the power balance between doctors en patients, and in the amount and availability of medical
information for laymen have had profound influences on the doctor-patient relationship. These
societal changes have fed and are fed by a paradigm shift in medicine: from supply-induced care to
demand-induced care, from doctorcentred medicine to patient-centred medicine, from clinical
decisions to shared decision-making. Each of these developments demand a revaluation of
communication as a relevant tool in medicine. The doctor-patient relationship in the context within
which patients' expectations and beliefs are shaped and management decisions are taken. This
relationship is changing over time and between cultures as well. Patient groups and individual
patients may have a variety of needs, expectations and preferences, which require tailored
communication by physicians. As a consequence, teaching general communication skills in medical
education is not sufficient anymore. Moreover, the shift from doctor-centred to patient-centred
medicine also implies a shift in focus from at the physician's to the patients's role in medical
encounters, with explicit attention to patients' illness representations and self-regulation in
disease management. By applying principles from health psychology, the medical encounter changes
from 'powerful placebo' into a place for 'empowering patients'. (aut ref.)
communication as the core instrument in the medical encounter. Adequate communication, embedded in a
warm and caring relationship, has always been recognized as essential to the concept of good
doctoring, but for long periods of time this was considered as 'the art of medicine', distinguished
and distinguishable from medical science. In the last decades empirical research has helped to turn
art into science. We will summarize the evidence, focusing on ' the placebo effect'. We will them
show that at about the same time that we began to understand the dynamics of the medical encounter,
the doctor-patient relationship itself was subject to major changes. Changes in patient morbidity,
in the power balance between doctors en patients, and in the amount and availability of medical
information for laymen have had profound influences on the doctor-patient relationship. These
societal changes have fed and are fed by a paradigm shift in medicine: from supply-induced care to
demand-induced care, from doctorcentred medicine to patient-centred medicine, from clinical
decisions to shared decision-making. Each of these developments demand a revaluation of
communication as a relevant tool in medicine. The doctor-patient relationship in the context within
which patients' expectations and beliefs are shaped and management decisions are taken. This
relationship is changing over time and between cultures as well. Patient groups and individual
patients may have a variety of needs, expectations and preferences, which require tailored
communication by physicians. As a consequence, teaching general communication skills in medical
education is not sufficient anymore. Moreover, the shift from doctor-centred to patient-centred
medicine also implies a shift in focus from at the physician's to the patients's role in medical
encounters, with explicit attention to patients' illness representations and self-regulation in
disease management. By applying principles from health psychology, the medical encounter changes
from 'powerful placebo' into a place for 'empowering patients'. (aut ref.)