Heroes Not Zombies

I was taught at medical school that the way to make a diagnosis (that is to understand what’s wrong with a patient) was to listen carefully to them (take a history) and examine them thoroughly. Only if the diagnosis remained obscure at this point would we subject the patient to any investigations. Sadly, there has been an increasing reliance on technology to the point where many doctors seem to be losing the ability to diagnose on the basis of listening and looking. A study from the University of Winsconin has shown another problem with this.

The researchers studied patients with acute appendicitis. They compared what happened to those who went straight to surgery after the diagnosis had been made clinically, and those who first went via a scanner room to have a CT investigation to make the diagnosis. Those who went via the scanner (two thirds of all the patients!) took longer to have their operation done than those who went direct to theatre (only a third of them). The scanner group had twice the rate of burst appendix (perforation) and twice the number of post-op complications.

Moral of the story? Don’t rely on machines as a routine way to make a diagnosis.

We need to make sure medical students and doctors know how to look and listen and make good diagnoses without relying on technology.