Who Was Michael Balint and What Can He Teach Us?

For a relatively brief biography see: Michael Balint – An outstanding medical life.1
Balint’s son, John, was a distinguished gastroenterologist, medical ethicist, and professor at Albany Medical College. I heard him lecture and it was there that I think I first learned about Michael Balint. At any rate, I became interested in Michael Balint’s opus major, The Doctor, His Patient and the Illness.2 The Sawyer Library at Williams College has a copy and I checked it out periodically over two decades, but found it a hard book to read as it was not well organized and choppy. Finally, in 2016, I ordered a reasonably priced used volume and decided to wade through it.

Early in the book Balint asks: “Why does it happen so often that in spite of earnest effort on both sides, the relationship between doctor and patient is unsatisfactory and unhappy?

My notes from The Doctor, His Patient, and the Illness are on Google Documents,3 and I will summarize the salient points for Hot Spots 2018. The book is a treatise on how medicine has lost its focus (if it ever had it!) on essential aspects of the therapeutic relationship. John Balint co-authored an article that discusses the important points his father made.4 They identified six salient themes that run through Balint’s work:

  1. The “basic fault” present in some form in all human beings.
  2. The physician’s “apostolic function.”
  3. The physician as a therapeutic agent—the drug “doctor.”
  4. The “conspiracy of anonymity.”
  5. The “deeper diagnosis.”
  6. The “mutual investment company.”

I will discuss these at the conference,  You can find the discussion at: Balint Hot Spots Google Docs.

References:
1. Edin Lakasing. Michael Balint — an outstanding medical life, Br J Gen Pract. 2005 Sep 1; 55(518): 724–725. Free Full Text.
2. Michael Balint, The Doctor, His Patient and the Illness.
3.Elpern’s Notes on The Doctor, His Patient and the Illness.
4. John A. Balint and Wayne N. Shelton. UNDERSTANDING THE DYNAMICS OF THE PATIENT–PHYSICIAN RELATIONSHIP: BALANCING THE FIDUCIARY AND STEWARDSHIP ROLES OF PHYSICIANS. The American Journal of Psychoanalysis, Vol. 62, No. 4, December 2002
5. Landmark article March 19, 1927: The care of the patient. By Francis W. Peabody. JAMA. 1984 Aug 10;252(6):813-8.

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About David Elpern

The Online Journal of Community and Person-Centered Dermatology (OJCPCD) is a free, full text, open-access, online publication that addresses all aspects of skin disease that concern patients, their families, and practitioners. ​It was founded in 2012 by Dr. David J. Elpern, M.D. in Williamstown, MA. with technical help from Inez Tan.

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