Journal of Continuing Education in the Health Professions



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CURRENT ISSUE BACK ISSUES SUBSCRIBE ADVERTISE ABOUT JCEHP FOR AUTHORS JCEHP AWARD SEARCH (Members only) FULL-TEXT		Volume 21 (3) Volume 21, Issue 3, Summer 2001 J Contin Educ Health Prof 2001; 21(3):170-181 INNOVATIONS IN CONTINUING EDUCATION Existential medicine: Martin Buber and physician-patient relationships Cohn F A b s t r a c t Martin Buber's (1878-1965) social existentialist thought offers a unique lens through which physician-patient relationships may be interpreted. Buber develops concepts of relationships and dialogue that provide insight into physician-patient relationships. His notions of I-Thou and I-It relationships have relevance for contemporary medical education and practice. Current medical practice is situated in the It-realm of order, objectivity, detachment, abstraction, and experience. This perspective is necessary for medical education and practice but can result in the progressive decline of the interhuman relationships that define medicine. I-Thou relationships, characterized by spontaneity, subjectivity, reciprocity, and recognition and acceptance of the unique other, are essential for humanhood. However, physicians and patients may be constrained from achieving I-Thou relationships by the very nature of their interactions, which are planned and purposive. Buber describes the possibility of a therapeutic relationship that approaches the I-Thou realm. Buber's thought suggests three conceptual shifts that facilitate the development of therapeutic relationships in medical practice and have implications for medical education: (1) from disease-centered to person-centered care, (2) from crisis to everyday management, and (3) from principles and contracts to relationships. Lessons for Practice A conceptual shift is needed in medicine from disease-centered and patient-centered medicine to person-centered care. Person-centered care involves defining diagnostic and therapeutic goals in terms of the everyday life and function of each individual patient. The mundane everyday matters of patient care should garner as much attention as crisis situations so that physician-patient interaction is ongoing rather than emergency focused. Medical practice and education should be framed in terms of relationships and codes so that they focus on the persons involved and personal interactions rather than the governing principles of professional conduct and ethics codes or contractual models. MeSH Terms: Education, Medical, Continuing; Existentialism; Physician-Patient Relations; Psychological Theory Publication Type: Review
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