Three stages of medical dialogue

Henry Abramovitch, Eliezer Schwartz

Research output: Contribution to journalReview articlepeer-review


The negative consequences of physicians' failure to establish and maintain personal relationships with patients are at the heart of the 'humanistic crisis' in medicine. To resolve this crisis, a new model of doctor-patient interaction is proposed, based on the ideas of Martin Buber's philosophy of dialogue. This model shows how the physician may successfully combine the personal (I-Thou) and impersonal (I-It) aspects of medicine in three stages. These 'Three Stages of Medical Dialogue' include: 1. An Initial Personal Meeting stage, which initiates the doctor-patient relationship and involves mutual confirmation; 2. An Examination stage, which requires a shift from a personal to an impersonal style of interaction; 3. An Integration Through Dialogue or 'Healing Through Meeting' Stage, which involves the integration of the impersonal medical data into the ongoing dialogue between doctor and patient, as a basis for shared decision-making. The use of the model, as well as common failures of doctor-patient dialogue are discussed.

Original languageEnglish
Pages (from-to)175-187
Number of pages13
JournalTheoretical Medicine
Issue number2
StatePublished - 1996


  • Communication
  • Compliance
  • Doctor-patient relationship
  • Medical dialogue
  • Medical education
  • Philosophy of medicine
  • Satisfaction


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