By Richard F LeBlond; Richard L DeGowin; Donald D Brown
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Extra info for DeGowin's diagnostic examination
Stories: Listen, Examine, Interpret, Explain The patient tells us a story of their illness. Our job is to create a story of their disease process that is congruent with their illness narrative. The key elements of a good medical story are the same as a good newspaper story: who, what, when, where, how, and why. " including their personal history (religion, beliefs, priorities), social history (education, sexual preferences, habits, demographics, employment, leisure activities), family history and past medical and surgical history.
Pattern recognition is the current English term describing this concept. Among the many clinical reasoning strategies, branching, matching and probability estimates are the most commonly used conscious processes when pattern recognition has not already occurred. Branching hypotheses. Clinicians sequentially form anatomic and physiologic hypotheses which are tested at the bedside or in the laboratory. As specific characteristics of the disease process are confirmed, etiologic hypotheses are generated and tested.
Sir James George Frazer PART 1 The Diagnostic Framework To carefully observe the phenomena of life in all its phases, normal and perverted, to make perfect that most difficult of all arts, the art of observation, to call to aid the science of experimentation, to cultivate the reasoning faculty, so as to be able to know the true from the false—these are our methods. —Sir William Osler Don't strain for arrangement. Look and put down and let your sensibility be the sieve. —Theodore Roethke "Poetry and Craft" …the framing of hypotheses is the most difficult part of scientific work, and the part where great ability is indispensable.