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Something in Nothing: Negative Space in the Clinician-Patient Relationship

Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand

CORRESPONDING AUTHOR: Stephen A Buetow, PhD, Department of General Practice and Primary Health Care University of Auckland Private Bag 92019 Auckland Mail Centre Auckland 1142, New Zealand s.buetow{at}auckland.ac.nz

ABSTRACT

Clinicians can easily miss the importance of how what is not present gives depth, perspective, and clues to the real meaning of social action in clinical encounters. This essay addresses examples of commonly overlooked forms of this concept of negative space in the clinician-patient relationship. The examples are negative physical space, which denotes the physical distances that separate clinicians and patients during face-to-face encounters; negative communicative space, which refers to how nonverbal and verbal communication can signify information not exchanged during these visits; and negative longitudinal space, which describes pauses over time and includes what is not said between clinicians and patients between visits. Discussed is how the awareness of these different spaces helps us to let go of our preconceptions, to experience what is there rather than what we expect to find, and to use space sensitively to improve interactions with patients.

Key Words: Negative space • physician-patient relations • patient care

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