Enduring Attributes of Medicine Relevant for the Education of the Physician

The thesis is advanced that the behavioral sciences basic for the education of the physician may be derived by identifying attributes of medicine that have endured despite changing dogmas, differing social climates, and evolving scientific knowledge. These include the complementarity of a need for help and a desire to provide service, a justification for medicine as a profession; the consistency of the processes involved in the transition from health to illness to patienthood; the interpersonal encounter between the patient and the physician, the keystone of medical care; clinical observation, the basic method of data collection; clinical reasoning, judgment, and decision-making, the analytic procedures of the physician; and the contract between patient and physician, a social and interpersonal bond. The implications for medical education and for the development of effective health care systems are discussed.