Shared presence in physician-patient communication: A graphic representation

William B. Ventres, Richard M. Frankel

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Shared presence is a state of being in which physicians and patients enter into a deep sense of trust, respect, and knowing that facilitates healing. Communication between physicians and patients (and, in fact, all providers and recipients of health care) is the medium through which shared presence occurs, regardless of the presenting problem, time available, location of care, or clinical history of the patient. Conceptualizing how communication leads to shared presence has been a challenging task, however. Pathways of this process have been routinely lumped together as the biopsychosocial model or patient, person, and relationship-centered care-all deceptive in their simplicity but, in fact, highly complex-or reduced to descriptive explications of one constituent element (e.g., empathy). In this article, we reconcile these pathways and elements by presenting a graphic image for clinicians and teachers in medical education. This conceptual image serves as a framework to synthesize the vast literature on physicianpatient communication. We place shared presence, the fundamental characteristic of effective clinical communication, at the center of our figure. Around this focal point, we locate four elemental factors that either contribute to or result from shared presence, including interpersonal skills, relational contexts, actions in clinical encounters, and healing outcomes. By visually presenting various known and emergent theories of physician-patient communication, outlining the flow of successful encounters between physicians and patients, and noting how such encounters can improve outcomes, physicians, other health care professionals, and medical educators can better grasp the complexity, richness, and potential for achieving shared presence with their patients.

Original languageEnglish (US)
Pages (from-to)270-279
Number of pages10
JournalFamilies, Systems and Health
Volume33
Issue number3
DOIs
StatePublished - Sep 1 2015

Keywords

  • Communication barriers
  • Medical philosophy
  • Outcome assessment (health care)
  • Physician's role
  • Physician-patient relations

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology

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