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January 7, 1998

The Spectrum of Medical Care: Curative, Rehabilitative, and Palliative

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(1):20-21. doi:10.1001/jama.279.1.17

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.