[Clinical rhetoric in the high school].

Clinical rhetoric is a science concerned with consistent patterns of speech behavior in different situations of interaction with colleagues, patients, and specialists in various disciplines with a view to extending their practical applications for the enhancement of efficiency of meaningful contacts. The history of this science as a means of rational communication with patients and medical profession dates back to the times of Hippocrates. Its importance greatly increased under the present-day conditions of high-technology and therapeutically aggressive medicine. Clinical rhetoric is based on the principles of general rhetoric. A clinician must be prepared for he fruitful and constructive relations with a variety of partners including patients, healthy subjects, administrators, lawyers, businessmen, and colleagues. Four main peculiarities of clinical rhetoric are distinguished: any debate is possible only in the form of discussion, both the form and content of the opponent’s arguments should be treated with respect, the speaker must himself draw attention to the weak points of his theses, all discussions must have the form of a “captain council” in which the shipboy is the first and the captain the last to speak. Traditional forms of clinical discussion include counselling, doctor’s rounds, consilia, and demonstrations. Collective forms of stimulating creative thinking, such as brainstorming and foresight have especially good prospects. These approaches appear to be of special value for the solution of heuristic problems. Teaching clinical rhetoric should be initiated since term IV when students begin to understand the role of a doctor as a key figure in the organization of the diagnostic and therapeutic process. Further development of Hippocrates’ traditions of collective communication may significantly promote the intellectual return from clinical and scientific discussions in medicine.