They conclude that patients are experts on their own personal and cultural background and their own story of the illness. The one-dimensional biomedical paradigm is insufficient for the comprehension of current medical knowledge, and more important, it is based on an inadequate and impoverished view of reality. They call for humility and patient centeredness in health care personnel, comparing change of a cherished or habitual life-style with the physiological response to loss and grief. Weston and coworkers have proceeded with the work on patient-centered method established by McWhinney. Less is known about therapeutic strategy and methods supporting behavior change.
Experimental evidence is sparse.
Their intervention improved patient control during consultations, but statistical methods seem improper to evaluate if the communication intervention improved health status. Although observational data show rather low correlation coefficients, the clinical relevance of these correlations are significant according to Ley. A one-way causal relation between comprehension, satisfaction and compliance seems, however, unlikely. What the clinicians say will always be interpreted in terms of the patients' own framework of ideas. Improvement of the communication should therefore imply exploring the ideas or health beliefs of the patient.