Comments on: Ohad Oren on counting symptoms or trusting intuition

By: Michal Oren

Michal Oren — Sat, 02 May 2009 11:14:08 +0000

Thank you for sharing with us your beautiful and illuminating thoughts about your medical experience. The question you pose is a one that I have long been contemplating. As I recall myself as a pre-clinical medical student, it always bothered me if someday, as a professional physician, I would be able to draw the imaginary notwithstanding very essential line between “pertinent clinical queries” and the “far fetched but statistically possible ones” that you relate to in your writing. As I see it now, from a much more clinical perspective taking into consideration all the limitations of the health care system (especially the one we have in Israel), no doubt medical staff cannot “afford” “wasting” its medical human resources when dealing, on the one hand, with straightforward diagnosis, while on the other hand more bizarre (and often lethal) diagnoses demand attention.

By: Dvoritte

Dvoritte — Sun, 19 Apr 2009 06:57:31 +0000

Very interesting point of view. I find that many long-experienced physicians, paradoxically though, tend to lose some of their awareness and curiosity, and are not as sensitive and attentive to seemingly-insignificant clinical clues as their patient would like them to be. What steps could be taken at medical schools to keep young medical graduates’ awareness and attentiveness to some of the bizarre triggers of modern diseases that very infrequently cause harm? Maybe create a journal section aimed at refreshing unusual clinical scenarios to prevent young physicians from being trapped in the ‘classical cases’ hazardous net?

By: Helen

Helen — Sun, 12 Apr 2009 13:08:27 +0000

As a practitioner in the professions allied to medicine, I am often confronted with a similar challenge as described by Ohad Oren - often my intuition tells me that a diagnosis is not a complete fit to a patient, and my conventional management strategies are doing more harm than good..

In the rushed world of medicine, much has been improved by clinical pathways, however the diagnoses which are statistically less likely are sometimes completely overlooked.

I know my medical colleagues feel pressured and get anxious if their diagnosis is contradicted, but I have the privilege of more time and a more specialized focus.

So please at least dignify my suggestions with a few minutes of your time, and I will do my best to present the evidence as a coherent whole.

It is not my wish to embarrass you, it is my wish that we work in partnership to give the best care for these patients, the difficult “heart-sink” ones you often send me!