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March 21, 1977

Improving the Effectiveness of Therapy

JAMA. 1977;237(12):1236. doi:10.1001/jama.1977.03270390052029

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The article by A. M. Gotto, Jr, et al (p 1212) describes the failure of patients to comply with a prescribed diet unless they were repeatedly counseled and instructed by a physician and a dietitian. This is a specific example of a larger, general problem, patient compliance in all areas of medical treatment. The physician may prescribe diet, medications, exercise, abstinence, and modification of life style, but if the instructions are not followed, the treatment stands no chance of success.

This is where the art of medicine must complement the science of medicine. It is not sufficient to establish the correct diagnosis, eg, type IV hyperlipoproteinemia, or to be cognizant of the prognosis without treatment. Nor does prescribing appropriate drugs and diet constitute wholly adequate treatment. The difficult and oftentimes consuming part of a complete treatment program is the obtaining of the patient's full understanding and enthusiastic cooperation. Without this