We make good care better

"At the center of medicine there is always a human relationship between a patient and a doctor."
Michael Balint

Clive Brock
Emeritus Councilor
2012 - present

I was introduced to the world of Balint training in the early 1970s by Dr Stanley Levenstein, who together with Dr Frank Dornfest participated in a Balint group in Cape Town, South Africa. Stanley sent me transcripts of each seminar and the process intrigued me, but I was much too wedded to the biomedical model to value the work.

In the mid-1970s, Stanley came to Durban on holiday and stayed with my wife, Phillipa, and me. After dinner one evening, I was in discussion with and a good friend and colleague Dr Jeff Kallmeyer. Jeff, a nephrologist, commented that I was a good general practitioner (GP), to which Stanley responded and how would you know? This was my AHA moment! It began to dawn on me that the discipline of General Practice includes more than the scope of care; it also involves a patient-centered clinical method informed by an understanding of the doctor–patient relationship.

>When Philippa and I decided to emigrate to the United States, I visited colleague and friend Hiram Curry, whose Department of Family Medicine was in Charleston at MUSC. This was in 1980. He offered me a job with the expectation that I was to start a Balint group. Thus, in 1981, my family and I immigrated to the United States to take that position, and I started a Balint group which included postgraduate year 2 and 3 residents.

I found throwing myself in at the deep end of Balint group leadership to be a nerve-racking experience, not knowing anything about group process, let alone the unconscious mind. Over time, I began to understand that the doctor–patient relationship literally meant that the two were connected by shared thoughts and feelings, and that the skill for recognizing and making sense of these connections was empathy. Thus, the empathic process may be seen as knowing one’s patient through oneself, and this would take training and some courage.

At present I’m semi-retired, and am still involved in co-leading a Balint group, with Dr Vanessa Diaz, whom I am supervising. Our cadre of Balint faculty in Charleston is still intellectually lively and I’m delighted to be included in their inquiries (Drs Alec Chessman, Vanessa Diaz, John Freedy, Marty Player, and Tam Psenka).

For a narrative of Dr. Brock's work with the ABS, consult his Emeritus Nomination.