Integration of the psychosomatic approach with internal medicine: development of concepts and preliminary results of evaluation of doctor-patient interaction.

Abstract

An account is presented of an attempt (made in the period between 1972 and 1979) to integrate a psychosomatic approach in routine patient care in a medical hospital. Following disappointment with a service run on a consultation-liaison basis, patient care on a small general medical ward was reorganized systematically according to psychosomatic principles. Within this relatively independent subsystem of the hospital, it was possible to integrate the medical and the psychosomatic aspects into a single approach. The organizational concept for the ward is described; first results are reported of an attempt to evaluate the factual changes in doctor-patient communication during the daily ward round. This communication was studied in the form of verbal contacts between doctor and patient. Finally a summary is presented of the advantages of the integrated approach over the traditional consultation-liaison service.