[The importance of the medical discussion for diagnosis in general medicine (author's transl)].

The process of diagnostic decision by the doctor was analyzed in 84 first consultations in 3 general practices. In 78 cases or 92.8%, a diagnosis was already made during the first consultation, in 50 or 64.1% on the basis of the discussion between the doctor and patient alone, in 28 cases or 35.9% of the first consultations additional diagnostic examinations were carried out by the doctor. Half a year after the first consultations to any diagnostic investigations at all. The medical conversation has been shown, therefore, to be the doctor's most important diagnostic instrument. Consequently, lack of attention to it in general medical training seems to be unjustified, the change in the patients in general practice makes a psychosomatic orientation of the conversation necessary.