Start   <  Monografien  <  Linus Geisler: Doctor and patient - a partnership through dialogue [1991]  -Contents-
Linus Geisler

Doctor and patient - a partnership through dialogue
- New ways of mutual understanding -

 Translation: Janet M. Massey M. D.
Online-publication with friendly permission of Peter Hoffmann/Pharma Verlag Frankfurt

Confession instead of a preface
Why discussions misfire
Setting and bases of discussion
The setting of the discussion
The physical environment
The time factor
Time pressure on the doctor - an insoluble problem?
The climate of the discussion
The correct distance
How much room does a person need?
Correct seating
Posture whilst sitting
Active listening
Technique of "mirroring" (reflection)
Techniques for interviewing procedures in mirroring (reflection)
How real is reality?
Discussion techniques - General principles
The 4 messages of speech
Anatomy of the signal
Hearing the signal
Comprehensible and effective language
Picturesque language
The style of speech
The art of questioning
The right question
Unproductive questions
Forbidden questions
Questions by the patient
Pauses in discussion
Pauses for decision
The pause as a means of contact
Pauses due to blocking
Pauses due to hindrances
The correct technique for pauses
Help for breaks in discussion
Not saying anything with speech
Commonly used "hindrance to communication"
The beginning of the discussion
Practical aspects of the initiation of discussion
The history
Basic principles
The two-person situation 
Dynamics of the doctor/patient discussion
History before the (initial) discussion
Opening phase
Adaption phase/thematization
Closing (termination)
Technical aspects
The closing of the discussion
Body language - an excursion
Eyes and eye contact
Specialized sections
Discussions to alleviate anxiety
Sources of anxiety
History of anxiety
Forms of anxiety
Strategies against anxiety
Prevention of anxiety
Recognition and differentiation of anxieties
The acceptance of anxieties and their demolition
A key to guide patients
What is compliance?
The problem of non-compliance
Causes of non-compliance
Measures which can encourage compliance
Doctor and patient on the telephone
Conflict and overcoming it in discussion
Approaches to a solution
Discussions with so-called "difficult patients"
Discussion with the patient with psychosomatic symptoms
The patient with psychosomatic disease
The diagnostic approach
The diagnostic-therapeutic discussion
Discussion with the chronically sick
Acute and chronic illness
From the viewpoint of the patient
Learning to cope with chronic illness
The doctor and the chronic patient
Discussion with the patient in pain
Acute versus chronic pain
The perception of pain
The diagnosis of pain
Influencing the perception of pain in discussion
Treating pain in those with tumors
The ward round
Suggestions for improvement
Discussion prior to and during stressful interventions
The pre-operative discussion
Discussion with older patients
The situation
The world of the old person
The limitations
Loneliness and social death
Coping with illness in old age
Capability in old age
Discussion with and approach to old people
Discussion with the suicidal patient
Recognition and assessment of likelihood of suicide
Dialogue after a suicide attempt
Conversations in intensive medicine
Present position
The 4 realities
The patient's reality
My heart stopped
Doctor and staff (the treatment team)
The relatives
Communication within intensive medicine
Looking after the relatives
Speaking with those who cannot speak - communication with aphasics
The world of the aphasic
Possibilities and limitations of speech therapy
Speech training
Mistakes in dealing with aphasic patients
Discussion with those who are seriously ill and dying
The situation
The difficulties
The objective
The road to death
The moment of truth
Anxiety and its defense mechanisms
The language
Possibilities and limitations
The opportunity
Questions about the meaning of life
One case history
Discussion with the person with AIDS
The epidemiological situation
The particular situation of the AIDS patient
The HIV test
Care of the AIDS patient
The AIDS patient and his relatives
Talking about God?
God in this day and age
The doctor as God?
The sick person seeking God
Questions and hopes
Ways and means
To hope for a miracle?
Eternal life?
Dialogue between doctor and patient - the nine steps from theory to application in daily medical practice
Check-list for unsatisfactory discussions
© Pharma Verlag Frankfurt, 1991   [ISBN: 3-92-668110-1]
Authorized online-publication:
URL of this page:
Prof. Dr. med. Linus Geisler
Bloomsweg 8   D-45964 Gladbeck   Tel: +49-2043-61281   Fax: +49-2043-204855   Mail:
Start  <  Monografien  <  Linus Geisler: Doctor and patient - a partnership through dialogue [1991]  -Contents-