[Difficult patients--difficult physicians?].

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.