Abstract
Beyond the increase in medical knowledge and biotechnology during the last decades, doctors have adopted professional norms that would have been considered heretical only two generations ago. The changes transpired between the 1970s and 1990s, and generated controversies between those who upheld the traditional values of patient care, and those who welcomed the new professional norms. Professor Dr Johannes Juda Groen (1903–1990) predicted and promoted some of these changes. As early as the 1940s through the 1960s, he recognized the need to teach interviewing skills and advocated an orientation to patients, rather than to diseases; he supported decision-making based on evidence, rather than on personal experience and pathophysiologic rationale; and he demonstrated that psychosocial determinants predict, rather than only correlate with, disease. These views led to confrontations with the medical establishments in the Netherlands and in Israel. Still, many of his colleagues recognized the value of his contributions. The author, for one, admires Groen’s commitment in challenging the prevailing clinical wisdom after the end of World War 2, and his courage in opposing the views of his colleagues.
Highlights
Today, doctors have adopted professional norms passive recipients of care, patients evolved to be that they rejected only two generations ago
Evidence-based medicine reautonomy replaced doctors’ paternalism, and, from placed clinical decisions grounded on personal ex
There was a move from denial to acceptance of clinical uncertainty and from the biomedical model of clinical practice to acceptance of psychosocial determinants of disease
Summary
Doctors have adopted professional norms passive recipients of care, patients evolved to be that they rejected only two generations ago. Professor Dr Johannes Juda Groen headed the department of Medicine A. His psychosocial orientation, reliance on evidence rather than personal experience, and promotion of what we would call today “patient-centered practice” challenged the prevailing style of clinical practice. Reliance on evidence rather than personal experience, and promotion of what we would call today “patient-centered practice” challenged the prevailing style of clinical practice It was only in the 1970s that I began realizing that Groen’s teaching was about 20 years ahead of its time.
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