Losing touch with the healing art: Dermatology and the decline of pastoraldoctoring

Technological advance in society and medicine has brought tremendous improv ements and convenience but also a degree of depersonalization. The personal and pastoral aspects of medical practice, which are probably more importan t in helping patients toward health than we realize, are becoming increasin gly stifled by health care systems which are increasingly "scientific," tec hnological, and "efficient." Clinical practice in dermatology requires past oral as well as technical skills, art as well as science, and yet the balan ce of current medical culture increasingly favors and encourages "science" over "art." In dermatology, this bias is evident in a reductionist focus of research, the move towards evidence-based medicine and the emergence of te ledermatology. Although all these developments are extremely important and valuable, their effect on the doctor-patient relationship needs to be consi dered carefully Increasingly rapid scientific advance is paradoxically prov iding diminishing returns for patients and the healing art is still very mu ch in demand.