The patient-physician relationship is under siege. I believe there are two sources that underlie the distress experienced by many patients and physicians in their interactions with each other. First, there is an intensification of the tension between the science and the art of medicine. Second, there are severe strains related to the rapid changes in the economics of medical practice.
Concern about tensions between the science and the art of medicine is hardly new. In the first paragraph of his landmark 1927 JAMA article, Francis Peabody noted that the most common criticism of young physicians of that era was that "they are too 'scientific' and do not know how to take care of patients."2 A physician can hardly be "too scientific" in the sense of having an understanding of a disease and the knowledge necessary to diagnose and treat it successfully. What Dr Peabody meant almost 70 years ago,