The place of behavioral science in medical education and practice.

Medicine and medical practice have undergone dramatic changes in the recent past. Technological advances have exceeded the norms of social thought (e.g., frozen embryos, surrogate motherhood, assisted suicide, and the right to die), and there has been a loss of professional control of the provision of medical services because of an inability to control the costs of technology and the patterns of practice. These and related changes find the profession of medicine, including medical education, without the necessary theory and content to adapt. The author explains why this situation makes it more necessary than ever to develop and upgrade the teaching of behavioral sciences in the medical curriculum, even though these disciplines' breadth and comparative lack of definition create special problems for the teaching and learning of behavioral concepts and their application to medical practice. The behavioral sciences are needed in medicine because their role is not that of a technologically defined knowledge area but rather that of a process or functional area that mediates between the patient as a person and the delivery of medical care. The author presents concepts, a diagram, and teaching examples that explain the characteristics of behavioral sciences and illustrate the necessity for including them in the curriculum. He concludes by urging the leaders of academic medicine to find practical ways to transmit an awareness of behavioral sciences' crucial role in patient care so that tomorrow's physicians can function more fully in the complex arena of clinical reality.