Hermeneutical Case-Understanding – an Approach to Understanding

DOI: 10.3238/zfa.2012.0355-0361

german translation / full article

Ottomar Bahrs

Keywords: Family Medicine Decision Making Complexity Approach Participative Research

Summary: Our health care system is considered to lack reasonable orientation, and as for the specific field of action in family medicine, it is particularly hard to convince medical students and graduates of its positive aspects. The present paper is based on the assumption that a „hermeneutical approach to the case in family practice“ – as discussed by experts – could create common ground for a clearer self-concept. However, it does not have any operational definition and is not part of education and training. In order to find hints for a hermeneutical approach, the text refers to the discussion of „The Patient as Text“, which is put up especially in English-speaking and Scandinavian countries. It points out that family medicine can be understood as a chain of interpretative actions and thus (also) as a hermeneutical venture. A recorded initial clinical interview illustrates a practical example of a hermeneutical approach which – in the case of family practice – is regarded as professional action that requires and promotes subjective competences by both the doctor and the patient. For the analysis, the unit chosen here for each case is “interview”, not taking into account that other units may be appropriate, depending on the respective focus of interest. One of the cases that needs to be understood is the case of the doctor himself. The analysis depicts that there is tacit knowledge in practice that could be used for education. Turning tacit knowledge into explicit knowledge would encourage a common ground for a clearer self-concept. Therefore, the concept of participative research is suited to make a „hermeneutical approach of the case in family practice“ trainable, learnable and replicable as a basis for family medicine.

(State: 18.09.2012)

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