Patients do not come with diagnoses attached to their foreheads. If only they did, huge numbers of hospital visits and admissions could be avoided. To overcome the ever increasing number of potential diagnoses, and the rising tide of illness encountered by our ageing populations, we rely ever more heavily on investigations to guide us […]
Tag: clinical judgement
Look not for the fleck in your brother’s eye, but the gorilla in your own…
Teaching for medical graduates approaching clinical exams such as the MRCP PACES exam is an anxious time. One is expected to ‘perform’ under pressure, wary of the need to elicit signs leading to potentially outlandish diagnoses. The breadth of knowledge and skills required to confidently identify CMV retinitis at one station, followed by a complicated […]
Three pipe chest pain…
Medicine is no longer quite so full of time to ponder as it once seems to have been. Rumination and consideration have taken a back seat to efficiency. Protocols and pathways seem to be the order of the day, and once a patient is on a pathway, it can be very difficult to get them […]
Wait – did I just hear a zebra going past?
There is an often quoted medical witticism, that originated in 1940’s Maryland: ‘When you hear hoofbeats behind you, don’t expect to see a zebra’ Suffice to say, there aren’t many zebras in Maryland… In the rough and tumble of acute medical admissions, there are an increasing number of horses in the herd to contend […]