RT Journal Article
SR Electronic
T1 Are we on the brink of a major transformation of clinical method?
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 873
OP 878
VO 135
IS 8
A1 I. R. McWhinney
YR 1986
UL http://www.cmaj.ca/content/135/8/873.abstract
AB The traditional clinical method, which has served medicine well for over 100 years, had its origins in the integration of physical examination with morbid anatomy in early 19th-century France. Now this method is showing signs of failing to meet some contemporary needs. In particular, there is no means for understanding the inner experience of patients. Previous models of a transformed method have not grappled with the problem of validation. Data on the inner experience of patients are not open to empiric validation in the same way as clinical data. The process of understanding the meaning of an illness is not, therefore, scientific in the conventional sense. There are, none the less, rigorous methods for validating the results of this form of inquiry, notably those of phenomenology. A transformed method should aim to understand the meaning of an illness for the patient as well as provide a clinical diagnosis. The transformation will require a change in the epistemology of medicine and an educational process that encourages reflection and growth of self-knowledge.