Spa treatments have up to now been offered too often, with too little exactitude of indication and too extravagantly. For many diseases success is not to be expected from the beginning from spa treatment. Patients who have themselves endagered their earning capacity through a way of life injurious to health should only be sent for spa treatment if they have already proved at home that they are capable of changing permanently to a rational way of life. Four accurately definable spheres of activity are proposed for an efficient, independant spa treatment (connected spa treatments, other spa treatments for specifically selected patients only, practising health education and behavior therapy methods, development of spa holiday systems for annual leave).