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ABCDE in Clinical Encounters: Presentations of Self in Doctor-Patient Communication
1Institute for Studies in History, Anthropology, and Archeology, University of El Salvador, San Salvador, El Salvador Department of Family Medicine, Oregon Health and Science University, Portland, Oregon wventres@gmail.com.
Abstract:
Professional discussions about communication in medical settings often ignore the various personal identities that doctors and patients bring to their clinical encounters. From my 26 years as a family physician, and informed by literature from other professional disciplines, I propose an alternate understanding: to think of doctors and patients as a collection of individual identities, each formed by a discrete presentation of self. I describe how at least 5 important presentations of self arise in clinical encounters, including those relating to meaning, community, agency, anxiety, and organism. I frame these presentations of self with the mnemonic ABCDE, briefly review key dimensions of each, and suggest how physicians can reflect on these dimensions in order to find equilibrium in their interactions with patients. Lastly, I submit that finding this balance can reduce relational challenges with patients and enhance the therapeutic effectiveness of doctor-patient communication.
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