[Skip to Content]
[Skip to Content Landing]
March 19, 1982

The Clay Pedestal: A Reexamination of the Doctor-Patient Relationship

JAMA. 1982;247(11):1633. doi:10.1001/jama.1982.03320360069048

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


When Dr Alan Nourse rocked organized medicine in the 1960s with The Intern, the establishment appeared astounded, shocked, and embarrassed. At the time we could not know that Nourse, with his pseudonym Dr X, was ushering in a wave of social change that has resulted in the dissection and, ultimately, in intimate understanding of health care delivery.

Tom Preston hides behind neither a pseudonym nor a white coat, nor even his earned title. Previous novelized criticisms have jousted with, poked at, and even taunted the stethoscopetoting, self-important, God-like beings, and nonfiction attempts have further bared the ripe underbelly. Although an internist-cardiologist by trade, Preston surgically eviscerates the body but does not let it die. He proposes solutions.

The problem, according to Preston, is that physicians have violated the "traditionally assumed contract between doctor and patient [which is]... only vaguely perceptible to a diffident public because of mystification and obscurity of