Logos, ethos and pathos in balance - the care of the patient and the soul of the clinic: person-centered medicine as an emergent model of modern clinical practice.
Bibliographic record
Abstract
In a recent discussion paper, Miles and Mezzich described person-centered medicine (PCM) as a model of modern medical practice that has emerged from the intellectual currents of the past century. In this commentary, we consider what PCM has to offer as a model for the clinical encounter and for clinical judgement. The doctor-patient relationship is an important thread in a person-centered medicine that visualizes the clinical encounter as a dialogue between 2 persons. Person-centered clinical judgement is concerned with the individual clinical case and as such is integrative, context-sensitive, interpretive and circumstantial. A care model incorporating these elements of dialogue and individualized judgement is ideal for older patients, for whom population-level guidelines are often inapplicable, who are often dependent on other persons and who are heterogeneous in their needs. As such a model, PCM is the dialectic synthesis arising out of decades of conflict between patient-centered medicine, and its antithesis, evidence-based medicine. If PCM is to progress from a prescriptive model to a descriptive model of modern medicine, its proponents must claim its philosophical commitments, keeping in mind that a model is fundamentally instrumental and not necessarily always literal. Medicine should look to a care model that is person-centered in the ways described here and that keeps the rational, virtuous and humane elements of practice in balance.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".