Publication: La relación médico-paciente en dos médicos humanistas españoles del siglo XX: Gregorio Marañón y Pedro Laín
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2017-09-04
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Universidad Complutense de Madrid
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Abstract
La relación médico – paciente, conocida hoy como relación clínica, viene siendo objeto de estudio empírico en los últimos decenios, ya que algunas variables en la consecución de la salud dependen de que dicha relación sea eficaz. Se conocen diferentes modelos de relación, sin que exista un acuerdo sobre un modelo que supere a todos los demás, de modo definitivo. Por ello consideramos que sigue siendo necesario complementar el avance empírico con una reflexión cualitativa. OBJETIVOS. Nos ha parecido oportuno explorar la contribución de figuras sobresalientes en el ámbito intelectual y médico, como fueron Gregorio Marañón y Pedro Laín Entralgo, al ámbito específico de la relación médico – paciente, tal como la denominaron ellos mismos. En el caso de Marañón, se ha revisado lo que escribió en las Obras Completas que Alfredo Juderías recopiló entre 1966 y 1978, ya que en ellas encontramos al “Marañón esencial”, si bien mucha de su obra no está recogida en ellas. En lo que a Laín Entralgo re refiere, se han revisado sus obras más directamente relacionadas con el tema objeto de nuestro estudio, ya que él lo abordó de manera sistemática, principalmente desde el punto de vista historiográfico. RESULTADOS En el caso de Marañón, es de destacar su énfasis en el abordaje global del paciente, en contraposición a la visión excesivamente fragmentada, propia de la especialización; su insistencia en la recogida detenida de los antecedentes y la realización concienzuda de la exploración física; la importancia de la cordialidad del médico, así como de aspectos equivalentes a lo que hoy denominamos empatía, la escucha del paciente, pretendiendo encontrar a este más allá de su propia enfermedad, son aspectos ya señalados por Marañón en su día, que siguen siendo eficaces hoy en día. Todo ello, teniendo en cuenta el modelo paternalista de relación predominante en su época y complementándolo. De igual interés es su llamada a la prescripción prudente...
The doctor-patient relationship, currently known as clinical partnership , has been studied in an empirical way in recent decades; it matters since some variables in the pursue of health rely on this relationship being effective. There appears to be different models of relationship, and the absence of an agreement on a model that clearly surpasses all the others. Therefore, we think that it is still necessary to complement the empirical progress with a qualitative reflection. OBJECTIVES. We decided to explore the contribution of Spanish medical and intellectual celebrities , such as Gregorio Marañón and Pedro Laín Entralgo, on the specific issue of doctor –patient relationship. In the case of Marañón, we've reviewed his Complete Works collected by Alfredo Juderías between 1966 and 1978, since we can study the 'essential Marañón' in there, even if there is only a part of his work on it. As regards to Laín Entralgo, we have reviewed the areas of his work that are directly related to the subject of our study, which he addressed in a systematic way. We've mainly attempted it from the historiographical point of view. OUTCOMES When it comes to Marañón, it seems of particular interest the importance he plays on the global approach to the patient, as opposed to the excessively fragmented vision that medical specialization brings within it. Marañon insists on detailed medical data record and a thorough physical examination; the importance of physician's good bedside manners, as well as aspects equivalent to what wéd nowadays call empathy: listening of the patient or attempting to find the human being beyond their own illness. These are issues that were identified by Marañon at that time and that are still effective today. We obviously need to take into consideration the paternalistic model of relationship predominantly at his time...
The doctor-patient relationship, currently known as clinical partnership , has been studied in an empirical way in recent decades; it matters since some variables in the pursue of health rely on this relationship being effective. There appears to be different models of relationship, and the absence of an agreement on a model that clearly surpasses all the others. Therefore, we think that it is still necessary to complement the empirical progress with a qualitative reflection. OBJECTIVES. We decided to explore the contribution of Spanish medical and intellectual celebrities , such as Gregorio Marañón and Pedro Laín Entralgo, on the specific issue of doctor –patient relationship. In the case of Marañón, we've reviewed his Complete Works collected by Alfredo Juderías between 1966 and 1978, since we can study the 'essential Marañón' in there, even if there is only a part of his work on it. As regards to Laín Entralgo, we have reviewed the areas of his work that are directly related to the subject of our study, which he addressed in a systematic way. We've mainly attempted it from the historiographical point of view. OUTCOMES When it comes to Marañón, it seems of particular interest the importance he plays on the global approach to the patient, as opposed to the excessively fragmented vision that medical specialization brings within it. Marañon insists on detailed medical data record and a thorough physical examination; the importance of physician's good bedside manners, as well as aspects equivalent to what wéd nowadays call empathy: listening of the patient or attempting to find the human being beyond their own illness. These are issues that were identified by Marañon at that time and that are still effective today. We obviously need to take into consideration the paternalistic model of relationship predominantly at his time...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina Preventiva e Historia de la Medicina, leída el 22-09-2016