Posted by: notdeaddinosaur | November 13, 2012

It’s the Diagnosis, Stupid

Not only have I begun repeating myself, now others are repeating me as well:

Me: Pay for the A – on the importance of diagnosis

Me: The Real Reason Medicine is Not Like the Cheesecake Factory (hint: We have to diagnose, they don’t.)

Dr. Bob Centor: Why Diagnosis is Job 1

Come on, people! This is so obvious even a Republican could figure it out. (Wait; bad example.) Before beginning medical treatment, there has to be a medical diagnosis. It helps if the diagnosis is the right one. Nothing good can come from a system set up to pay for treatment without adequate attention to diagnosis (see: allergic reactions to antibiotics given within 4 hours for pneumonia with no pneumonia present).

Diagnosis, like treatment, can be aided BUT NOT SUPPLANTED by technology. You can google differential diagnoses, but you still need to have enough knowledge, experience, AND TIME to obtain an accurate history, perform an appropriate physical exam, and interpret necessary studies and images. No artificially intelligent series of self-administered online questionnaires can even come close to replacing this process, despite what some venture capitalists would have you think.

We have to fix this. How? Get government non-clinicians OFF OUR NECKS about treatment decisions without PAYING US to correctly diagnose our patients. Then PAY us to diagnose. Simple. (Easy? Of course not. Still has to happen.)

Sorry for shouting.




  1. SIng it! I don’t love my internist because she has a prescription pad and my health insurance’s authorization to refer me to specialists. I love my internist because she’s good at helping me stay healthy and at figuring out what’s wrong with me (and how to fix it) when I’m not.

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