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[The physician-patient relation through a Balint group]
M Fernández de Sanmamed1, C Iglesias, A Moretó
1Societat Catalana de Medicina Familiar i Comunitària, Mallorca, Barcelona.
Objective:
To evaluate by means of a contents analysis a Balint Group (BG) after 7 years in operation, to find which type of patients are most disturbing for the General Practitioner and to analyse the sort of feelings they provoke.
Design:
A retrospective descriptive study which uses qualitative analysis methodology.
Setting:
The BG under analysis was created in the heart of the Catalan Society of Family and Community Medicine in 1984.
Patients:
21 sessions were analysed, covering 18 patients.
Interventions:
The variables studied were: the motives for presentation, the sort of patient presenting and the doctor's feeling towards them.
Measurements And Main Results:
Two types of patients stood out: those with somatization disorders and those with a very poor prognosis. The first (12 out of 18) unsettled the professional and caused him/her to lose grip on his/her role. The GP often trivialised their requests or thought they were pretending. Those sessions analysed where patients had a poor prognosis made clear the high degree of empathy shown by the doctor. Questions were raised as to how to tackle the illness both with the patient and his/her family. Feelings of distress, fear, anguish-exhaustion-impotence and rejection-aggression of the doctor towards particular patients were analysed.
Conclusions:
The questioning of the doctor's social role or professional identity by particular patients makes it difficult for him/her to maintain a long-term therapeutic relationship with them. The BG was useful for the participants, because of the group dynamic and also because they found out the possibilities and limitations of their treatment.