Schläpfer A
Praxis (Bern 1994). 1996 Jul 2;85(27-28):870-6.
It is a great chance for the general practitioner to encounter the entire ill human being as it lives and suffers in an integrative manner. He invites the patient to describe the picture of his situation. Pantomimic meaning of the physical appearance as well as verbal and spiritual expressiveness are important. Difficulties in the patient-physician relationship arise when physician and patient value psychic and somatic aspects of the disease differently and when they disagree on therapeutic goals. Often patients degrade themselves to a defective machine, to a dysfunctioning computer--and the physician to a mechanic. When the physician rejects the patient's passive consumer attitude and when he demands active cooperation from the patient to carry a part of the responsibility for diagnosis and therapy, he develops into a 'difficult' physician.
对于全科医生来说，以综合的方式接触活生生且正在遭受病痛折磨的完整病人是一个绝佳机会。他请病人描述其病情状况。身体外观的模仿性含义以及言语和精神表达都很重要。当医生和病人对疾病的心理和躯体方面的重视程度不同，以及在治疗目标上存在分歧时，医患关系就会出现困难。病人常常将自己贬低为一台有缺陷的机器、一台运转失常的电脑——而将医生贬低为机械师。当医生拒绝病人消极的消费者态度，并要求病人积极合作以承担部分诊断和治疗责任时，他就成了一名“难相处”的医生。
