A contributor to Kevin, M.D. has an interesting post, which also comments on the writings of Dr. Jerome Groopman who has published on the patterns of physician errors in decision-making. I posted on Dr. Groopman's book before, and highly recommend it.
Overall, I agree that correct diagnosis or identification of medical problems is an art as well as a profession. Additionally, I do see that things that can make this more difficult than it already is include inadequate communication and over-reliance on technology.
On the other hand, most of this knowledge should be imparted in medical school and residency training. A great deal of medical education includes learning what lab and imaging studies can do, and what they also cannot do.
I am happy that my teachers imparted several valuable lessons for which I remain grateful and have helped me a great deal:
- "Let the patient talk for at least the first several minutes without interruption." (No one likes to be interrupted, and you'll learn more about what you want to know.)
- "90% of arriving at the correct diagnosis is based on adequate history-taking. Examination and tests rule-out or confirm your impressions." (This is the time-consuming asking of the right questions and paying attention to the answers. This is never wasted time.)
- "Ask whether the patient has any questions." (It's polite, and also helps to make sure everyone involved is "on the same page.")
- "Ask the patient what they think is going on: at least half the time they'll be right and save you a lot of trouble." (Yep, pretty much!)
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