Patient care

Is there still an art to practicing medicine?

Practicing medicine can take on many forms and styles, based upon what we’ve seen and learned. Let’s talk about whether the concept of the art of medicine still applies today.


Art is the subjective, interpretative creation of a subject (painting, monument, etc.) created by an artist. This piece is then seen through the lens of the viewer, who has a different set of thoughts and beliefs about what they are seeing based on their personal life events and history.

Medicine is the application of scientific data to treat disease. In modern medicine this has become defined as the standard of care, which is built by evidence-based recommendations within the construct of scientific truths. Practicing in medicine can take on many forms and styles, based upon what we’ve seen and learned.

In what world do these two constructs collide or intertwine? We have all heard of the mantra instilled in the teaching of medicine: “the art of medicine.” From our early days as medical students to our senior years as attendings, it has persisted. In a recent conversation with a medical student this topic came up, and the resultant conversation had us asking, “Is there still an art to medicine?”

The landscape of modern medicine

Medicine is complex and varies across specialties, so the answer is unlikely to be a black-and-white one. That being said, I favor those who say “the art of medicine” has no place in the modern landscape that we currently practice in.

Now let me explain, as I know some of you might immediately disagree. Medicine in its simplest sense is consideration of patient-reported details to formulate a thorough history, a physical exam with specifically detailed and described tests (McMurray, rebound tenderness, modified balance error scoring system, etc.) and development of a likely differential diagnosis with the resultant ordering of test, studies and consultations.

Within these building blocks, there is a right and a wrong way to do things. The resultant treatment phase of medicine is also guided by evidence-based recommendations, and sometimes based on nationally published guidelines. These best practices form the facets of treatment, from first-line pharmacological recommendations to surgical repair of athlete ACLs to lifestyle intervention for obesity based on patients’ BMI.

Education and communication lead to various approaches

In the day and age of litigation and standards of care, we recommend and educate our patients under these tenets.

Now, there are aspects to medicine that encompass a holistic and possibly artful approach, but these lie more within the realm of patient communication, conversation and education. The clinical direction of data collection can be a learned artful skill, which varies among physicians.

How to ask the right questions and the ability to obtain the important historical facts is imperative in medical scenarios. This requires understanding of the patient to obtain the correct objective information required to inform accurate diagnosis and development of appropriate treatment plans.

However, we have created standard template questionnaires in an attempt to decrease variation, i.e. date of injury/illness, symptoms, what has made your symptoms better or worse, etc. This is engrained into medical education again to standardize practice and reporting (OPQRST, OLDCARTS).

Perhaps one could say there is an art to manual medicine, such as osteopathic manipulative treatment (OMT). Although two physicians treating the same patient could perform different techniques with varying degrees of pressure or force, the physicians are still practicing techniques that have been described and supported within the literature.

Thus, even OMT as a skill is completed through a series of prescribed steps and with recommended position, direction and force. Medical literature and current evidence supporting the wide range of benefits of OMT again is very specific regarding the technique used to obtain the supporting evidence. The standard that is expected is tested by the American Osteopathic Board of Family Physicians with reliability and reproducibility through the OMT Performance Examination.

Perhaps there is still an art and style to medicine in the area of new diagnostic evaluation and treatment. Take the recent COVID-19 pandemic, for example: treatments have varied among regions, organizations and providers. Researchers tested hypotheses and clinicians shared educated opinions without the previously described standard of care.

Thankfully, as evidence became available and guidelines were created, practice styles became more uniform, allowing proper treatment of the illness.

We practice medicine that is shown by science to be effective. Also, medical litigation focuses on practice variation and draws attention to a more artful-type practice. Although treatment with the defense of guideline use does not protect a physician from litigation, the decreased variation of practice does provide some protection to both the physician and the patient.

How the art of medicine looks in today’s world

The romantic rhetoric of the art of medicine may exist, but this is only in the delivery of information, and in those fields of new discovery where evidence is minimal and hypotheses are still developing. As a community, we continue to change with our evolving and modernizing world.

However, so-called “cookbook medicine” relying on guidelines and protocols rather than a comprehensive approach to the individual patient is not entirely capable of evaluating all patients satisfactorily and considering those “zebras” we all chase. It also does not catch unlikely diagnoses or combinations of diagnoses that we know can cause morbidity and mortality.

If you have been evaluating current developments, you are aware of the convergence of human and artificial intelligence (AI) for the creation of machine-learning software.

We are on the horizon of a new challenge, with the utilization of big data that will begin to put on trial the evaluation and treatment of patients through the use of AI and machine learning. Objective measures can be constructed to aid in patient management through “modeling work.”

How will this influence our clinical practice? How will patients feel if it opens more access to care? We are at the precipice of modern medicine, the application of big data sets to teach models to aid physicians in evaluation and treatment. 

The goal of health data science is the progression toward an efficacious and cost-effective clinical tool. I would encourage everyone to take a step back and draw focus to the scientific medicine that is expected; the guideline-driven medical recommendations we all practice.

Editor’s note: The views expressed in this article are the author’s own and do not necessarily represent the views of The DO or the AOA.

Related reading:

The DO Book Club: Heartsounds, Echoes of Heartsounds, Changing How We Think About Difficult Patients

Medicine as your Second Life: What happens when the game ends?


  1. Steven Kamajian

    Ah….all professions (and medicine is still a profession)require passion and art. The very reason it is called cook book medicine is precisely because by removing art, medicine becomes a craft or a
    skill which is totally reproduceable and eventually derivative. There is an art in listening. There is an art in understanding the patient’s narration, to read between the lines and know when to question. There is an art to giving peace of mind. There is an art to caring and developing relationships with the patient (NOT with the computer), there is an art in understanding what a patient is willing to do, able to do, understands to do and is encouraged taught to do. Ten minutes spent on electronic documentation (most of which is totally faked and never done by the clinician (note…not the doctor…a doctor would not fill out the EMR for the sake of billing or management) ten minutes spent on the EMR documentation with 5 minutes spent examining and talking to the patient is not art….can’t ever be art. So if you want the profession of medicine to disappear become craft without art. Every society , every culture has empowered physicians with respect and authority. We are voluntarily giving up that so that we can complete our electronic charting. Drop down menus do not require a physician. Whomever programs the drop down options, will replace the physician with whatever the least expensive and least educated and least quarrelsome option might be.

  2. Steven Kamajian

    Four men dressed as the 1960’s Beetles Rock band, playing and sounding exactly like the Beetles-those four men are not artists. There is no authentic experience listening to them. Their work is totally derivative. The artist experiences the world,takes that experience internally and then expresses themselves in anauthentic manner so that whoever sees the art
    has an expended unique experience.Why do we educate physicians so extensively. It is precisely so that they can understand and relate to the patients that they care for. It isn’t because the physician is expected to click a drop down menu. Remove art and you will remove the physician’s place in society and you will replace the physician with the computer programmer who created the drop down menu. No humanity in that. No caring in that. No ability to attract creative people into the profession. Go down this path and watch the destruction of this regal profession and its conversion into a job.
    Oh-hasn’t this already begun as physicians sit around now and talk about the job they have-and how they look forward to retirement.Burn out-all of this is direct result of removing
    the creativity and art from the profession. Seek wisdom in this:
    The easiest way to make an artist sick is to prevent them from doing their art. If a person wants to be an artist and their parents force them to become a CPA for practical and economic reasons-unless the CPA finds some outlet, some method of “doing their art”-they will become sick

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