Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—The Editorial by Dr Fox1 insightfully explains the need for reforms in medical
education that will enhance a flexible mix of curative and palliative approaches
in medical practice, approaches fashioned to the needs, value systems, and
specifics of individual patients rather than to diseases and organ systems.
"For most patients neither a purely curative model nor a purely palliative
care model is altogether suitable, . . . [since] most have chronic disabling
conditions as well [as curable conditions]." Fox concludes, "Reframing the
problem with medical education in terms of its relative emphasis on the various
models of medical care may help to marshal resources to effect essential changes
in medical school curricula and graduate medical education programs." I agree
wholeheartedly with this approach, but I have a suggestion that the semantics
of her curative vs palliative care models need modification.
Sapir M. The Spectrum of Medical Care: Curative, Rehabilitative, and Palliative. JAMA. 1998;279(1):20-21. doi:10.1001/jama.279.1.17