Healing in Primary Care: A Vision Shared by Patients, Physicians, Nurses, and Clinical Staff

Clarissa Hsu; William R. Phillips; Karen J. Sherman; Rene Hawkes; Daniel C. Cherkin

doi:10.1370/afm.838

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Healing inherent in Patient-Physician consultation
Waris Qidwai

Published on: 21 July 2008
The Importance of Naming
John G. Scott

Published on: 18 July 2008

Published on: (21 July 2008)
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Healing inherent in Patient-Physician consultation
Waris Qidwai, Karachi, Pakistan
I must congratulate the authors on raising the important issue of “healing” through research and scientific media. “Healing”, supposedly takes place through a process that draws upon powers of nature, science, and physician1. Its occurrence during a Patient-Physician consultation has been debated prior to the Hippocratic period2. Research on such an abstract concept which can’t be seen or visualized renders its validatio...
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I must congratulate the authors on raising the important issue of “healing” through research and scientific media. “Healing”, supposedly takes place through a process that draws upon powers of nature, science, and physician1. Its occurrence during a Patient-Physician consultation has been debated prior to the Hippocratic period2. Research on such an abstract concept which can’t be seen or visualized renders its validation and quantification very challenging. It is said that patients feel half cured if they are satisfied during consultation with the physician. Even a physician’s appropriately applied touch is reported to have healing properties3. In clinical practice, we encounter health issues with no known cause and therapy, leaving the patients essentially on palliative care for a lifetime. In such cases, utilization of healing properties of a Patient-Physician consultation is a very useful option. The competence of a Physician, individual attention given by Physician and a cool/calm attitude of Physician are reported to increase healing for the patient, during a Patient-Physician consultation.4 Present day allopathic practitioners are reported to lack a holistic perspective, causing patient dissatisfaction and forcing many to seek help from ‘alternative’ practitioners, who devote time and listen to their concerns5. It appears that modern day practitioners have stopped exploiting the healing properties of the Patient-Physician consultation. Our overwhelming focus on the biomedical diagnosis and pharmacologic management of diseases has lead us to give less importance to psychological, social and spiritual aspects of medical care, thereby depriving us of the potential healing inherent in a Patient-Physician consultation. It has been argued that healing for the patient, during a Patient- Physician consultation, occurs through a placebo affect. The basic assumption is that a patient has a mind and a body and the two can influence each other. It has been argued that the placebo affect on the mind of a patient, occurring during a consultation, results in a positive therapeutic affect on the body of the patient with lowering of blood pressure, increase in immunity to fight infections, decrease in pain and even healing of ulcers. Modern day medical practice is losing personal touch, becoming more technical, investigation oriented and defensive. The focus is not on a person as a whole, but rather on a system or an organ supposedly at fault, that requires fixing. The disintegration of medical practice today with less focus on holistic approach is resulting in loss of healing properties inherit in the consultation process.
References
1. Szawarski Z. Wisdom and the art of healing. Med Health Care Philos. 2004; 7(2):185-93. 2. Marketos SG, Skiadas PK. The modern hippocratic tradition. Some messages for contemporary medicine. Spine. 1999; 24(11):1159-63.
3. Ventegodt S, Morad M, Merrick J. Clinical holistic medicine: classic art of healing or the therapeutic touch. ScientificWorldJournal. 2004; 4:134-47.
4. Qidwai W, Ali SS, Ayub S, Ayub S. Healing during Physician-Patient consultation. J Coll Physicians Surg Pak. 2005; 15(11): 689-693
5. Veeramah EK, Holmes S. Complementary therapy: complement or threat to modern medicine? J R Soc Health 2000;120(1):42-6
Competing interests: None declared
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Competing Interests: None declared.
Published on: (18 July 2008)
Page navigation anchor for The Importance of Naming
The Importance of Naming
John G. Scott, New Brunswick, NJ, USA
It is gratifying to see in this issue of the Annals that three independent investigators have been exploring the phenomenon of healing. One of the difficulties in studying healing has been the lack of a common definition. This paper by Hsu and her colleagues goes a long way toward remedying that problem. A particular strength of this study is the inclusion of nurses, MA’s and patients as well as physicians in the foc...
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It is gratifying to see in this issue of the Annals that three independent investigators have been exploring the phenomenon of healing. One of the difficulties in studying healing has been the lack of a common definition. This paper by Hsu and her colleagues goes a long way toward remedying that problem. A particular strength of this study is the inclusion of nurses, MA’s and patients as well as physicians in the focus groups. The fact that all these diverse groups had similar definitions of healing is remarkable and strengthens the validity of the findings.
Using a different qualitative interview design, my colleagues and I came up with a very similar definition of healing in our paper elsewhere in this issue, again suggesting the robustness of the domains that Hsu et. al. have identified. Although neither group was aware of the work of the other until recently, the studies have turned out to complement one another nicely. Hsu et. al. identified relationships as an essential component of healing, and our study focuses on the structure of those relationships. There is much more work to be done in this area, but none of it can proceed without a common understanding of what constitutes healing. Hsu and her colleagues have made a major contribution in this regard.
Competing interests: None declared
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Competing Interests: None declared.