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Dear James,
great article on a person-centered and goal-oriented medicine.
To promote the integration of these aims within the daily medical decision-processes is also one of my basic interests.
Unfortunately, the needed medical attitude and communication skills to include the patient in a solution- and goal-oriented person-centered medicine are not or only insufficiently taught at most medical schools.
From many years of cooperation with experienced doctors, we have learned that there is a real need for repeated reflection on one's own medical practice and professional attitude, as well as for training the necessary communication skills. Preferably in supervised peer group meetings.
All our experience we have summarized in the book "Mastering the Medical Consultation - A Systemic, Solution-Oriented Process", Bruno Kissling, Peter Ryser, Free Association Books, London, 2021. (The German Original being awarded with the Book Prize of the European Society for Person-Centered Healthcare ESPCH)
The book goes through the consultation, step by step. It contains a pracitcal tool with samples of questions which involve the patient actively within the whole analyzing, "assessing" and therapeutic process. We show ways, how to build a sustainable relation between doctor and patient (the foundation of any collaboration); how to meet the patient on an equal footing - like two experts: the patient being the expert of their unique disease / illness, their psycho-socio-economical context, goals, values, beliefs, experiences and resources. The doctor as an expert of medical knowledge, their professional experiences and, not to forget, whomis always aware of the influence of their personal convictions. We show, how both, doctor and patient can reate a common reality, cope with uncertainty and ambivalence and go through a shared decision making process...
In the book we reflect also the reasons, why the proposed open-ended ways function.
To read a book is a good first step to wake the interest for the item, but we are convinced, that the communication skills have to be trained like all other medical skills, preferably in supervised groups.
We see the book as a contribution to the discourse about the urgently needed re-integration of the medico-technical advances and the patient as a person with their very personal values and goals. We stand for a medicine with the patient in the center of the interest. - A prerequisite for a medicine of high quality and satisfaction for both, the patient and his family, and not less for the doctor...
Let us go ahead.
Best wishes
Bruno