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A Journal on Internal Medicine

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Minerva Medica 2008 August;99(4):411-5

Doctor-patient communication: a historical overview

Conti A. A. 1,2,3, Gensini G. F. 1,2,3

1 Department of Medical and Surgical Critical Care University of Florence, Italy
2 Foundation Don Carlo Gnocchi IRCCS S. Maria agli Ulivi, Florence, Italy
3 Italian Center for Evidence Based Medicine, Florence, Italy


Doctor-patient communication is an issue that is attracting more and more attention within the international scientific community, stimulating an interest involving many different health contexts, from academic to medico-legal ones. In the academic setting, the insertion of health communication courses into the curriculum has been a recent renovation, given that in the past such training was not considered a necessary formative step. In the medico-legal scenario, among the main causes of legal action is an incorrect, incomplete or non-existent transmission of information. Doctor-patient communication is therefore an extremely up-to-date topic, the problematic of which may already be discerned in Western medicine in the so-called Hippocratic Oath. In this paper the historical roots and the evolution through time of doctor-patient communication are discussed, together with the description of the predominant models of communication of the past (the physician-centred and the disease-centred approaches) and of the present (the patient-centred and the person-centred paradigms). Nowadays complete, correct and comprehensible communication is a primary exigency for the physician, for the patient/person and for all the organizational levels of the sanitary system. Every physician and, more in general, every health operator, must therefore learn to communicate effectively in the course of his/her medical training, and must continually refine this capacity during his/her professional career.

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