John Libbey Eurotext

Médecine

The choice to prescribe: the contribution of the Balint groups Volume 13, issue 7, Septembre 2017

Author
Psychologue clinicienne, Hôpital Saint-Antoine, service d’hématologie et thérapie cellulaire, 184 rue du Faubourg Saint-Antoine, 75012 Paris
* Tirés à part
  • Key words: prescriptions, physician-patient relation, psychoanalytic therapy, balint
  • DOI : 10.1684/med.2017.231
  • Page(s) : 321-6
  • Published in: 2017

The preponderance of drug prescribing in the practice of French general practitioners no longer needs to be proved. 91% of consultations with general practitioners are followed by a pharmacy prescription. 40% of prescriptions for 80 years old patients or older include medications with insufficient evidence of medicine benefits and the rate of inadequate prescriptions – the use of drugs for which risks exceed the expected benefits – in the elderly it reaches 21%, causing iatrogenic incidents. The incidence of iatrogenic problems is 50/1000 persons/year, of which 27.8% is due to prescription errors, and accounts for 10% of hospitalizations in subjects ≥70 years of age.

These findings raise many questions about the determining factors of medical practice. What is the impact of the physician-patient relationship on the patient's behavior, as well as on the practitioner's attitude... and vice versa ?

The physician's awareness of the strictly therapeutic function of the physician-patient relationship must enable him knowingly, depending on the situation, to prescribe or not to prescribe medicine, to cancel prescriptions, or even to stop the treatments after a delay.