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JAMA Revisited
February 11, 2020

Art of Therapy

JAMA. 2020;323(6):576. doi:10.1001/jama.2019.13301

Originally Published February 9, 1970 | JAMA. 1970;211(6):1002.

References have been made in news media and elsewhere to the decline of personal attention in medical care. The physician-patient relationship that allows or prevents personalization includes, among other factors, the art of therapy.

Although therapy is ordinarily thought of as deriving from symptom analysis and diagnosis, as indeed it should when it is to be specific, there is more to it than that. In their first contact, by the nature of the physician’s manner and manners, the patient may obtain reassurance, which is beneficial, or little reassurance, which is hurtful.

Diagnostic procedures themselves may make the patient feel better, either because he recognizes the value of thoroughness or because he doesn’t understand them at all. On the latter point, I recall the case of an elderly man with severe jaundice ultimately diagnosed as hepatitis. After several days in the hospital, he announced that he was feeling much better as a consequence of the treatment that had been prescribed, especially the bloodletting. He was referring to withdrawals of relatively small amounts of blood for diagnostic tests.