A minority of people experiencing chest pain have a problem with their hearts (p 588). Indeed, as our ABC of psychological medicine has made clear, a minority of patients with most symptoms have an organic cause defined in a medical textbook. “The tragedy for doctors,” said Simon Wessely, a professor of psychiatry from London at a recent meeting at the Royal Institution, “is that they spend their time at medical school learning about the organic causes and then the rest of their lives dealing mostly with patients with non-organic problems.

The traditional model of care for patients with chest pain …