BACKGROUND Previous empirical work among physicians has led us to propose that clinical practice is experienced by clinicians as an engagement-in-the-clinical-situation. In this study, we pursue our exploration of clinical practice 'on its own terms' by turning to the experience of patients. METHODS Phenomenological analysis of in-depth individual interviews with 8 patients. RESULTS We describe the patient experience as a set of three motifs: the shock on the realization of the illness, the chaos of the health care environment, and the anchor point provided by an engaged physician. We draw on Heidegger's notion of solicitude to show that patients are actively ascertaining the physician's engagement in their care. CONCLUSIONS These findings lead us to question the classical "dual discourse" of medicine that offers a dichotomous account of clinical practice as the addition of care to cure, art to science, humanism to technique, and person to medical case. We found no such distinctions in our empirical investigation of clinical practice. Rather, in our synthesis, practice appears as a unitary experience. The physician's solicitude for the patient entrains engagement in the clinical situation. Moreover, the solicitous, engaged physician constitutes an anchor point for the patient.

中文翻译：

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对临床实践的实证和哲学探索。

背景技术先前医生的实证工作使我们提出，临床实践被临床医生体验为一种参与临床情境的体验。在这项研究中，我们通过转向患者的经验来“按照其自身条件”对临床实践进行探索。方法 对 8 名患者进行深入的个体访谈进行现象学分析。结果我们将患者体验描述为一组三个主题：意识到疾病的震惊、医疗保健环境的混乱以及敬业的医生提供的锚点。我们借鉴海德格尔的关怀概念来表明患者正在积极确定医生对其护理的参与程度。结论 这些发现使我们对医学的经典“双重话语”提出质疑，这种话语对临床实践提供了二分法，即护理与治疗、艺术与科学、人文主义与技术、个人与医疗案例的相加。我们在临床实践的实证研究中没有发现这样的区别。相反，在我们的综合中，实践表现为一种单一的经验。医生对病人的关心促使他对临床情况的参与。此外，热心、敬业的医生构成了患者的锚点。