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Student Reviews

Balint groups: psychosocial nonsense or a real insight into the doctor-patient relationship?

BMJ 2004; 328 doi: (Published 01 April 2004) Cite this as: BMJ 2004;328:0404172
  1. Bruno Rushforth, final year medical student1,
  2. Wendy Brown, intercalating medical student2
  1. 1University of Manchester
  2. 2University of Dundee

We have all come across them, but how should we react? That patient who keeps returning to their family doctor, with volumes of notes, numerous letters from specialists, but no disease is ever found. Or the patient who has not visited the doctor for 20 years and then presents with depression but says he or she does not want to talk about it. And then there is the patient who keeps bringing you gifts. This is where psychosocial medicine comes in. Love it or hate it—you cannot ignore it.

Around the world, medical training is increasingly demanding an understanding of patients' problems that goes beyond the organic nature of disease. Some students resent having to study these “soft” behavioural and social sciences, which take them away from the “real” medicine of anatomy, physiology, and pharmacology. Yet to ignore the powerful influence of health beliefs and emotions is to deny the psychosomatic dimension of many patients' presentations.

A key element is how the doctor responds in the consultation room. Indeed, the doctor-patient relationship itself can be a powerful therapeutic tool. But it is also important to acknowledge how some patients make us feel. Understanding our own emotional responses to difficult consultations can sometimes shed light on the patient's underlying problems.


To explore these issues in the doctor-patient relationship we attended a weekend in Oxford, organised by the Balint Society. Who are they? Good question-until the advert appeared in the Student BMJ we had not heard of them either.

The UK Balint Society is part of an international federation of …

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