Recognition of the contributions to this listserv

Lenny Hoffman lenhoffman39 at GMAIL.COM
Mon Aug 19 15:58:10 UTC 2013


I have been impressed with the contributions made by many academicians and
others and am looking forward to attending the conference in Chicago.
After practicing medicine, Pediatrics, Allergy and Immunology, etc for over
40 years, I have become aware that the difficulty in making the right or
correct diagnosis is sometimes made more difficult by having to classify
the failure of health by either organic or functional or psychogenic
causes. I do not think they can be readily separated. I  also am struggling
with implementing the computer into my practice; I see all the advantages
but definitely see the problem in focusing on the "electronic space"
created between the patient and me.
I also fear that the constraints being placed on medical expenditures as
necessary as they are can promote errors in diagnosis.
With exacerbations in asthma, I avoid repeatedly requesting an xray  of the
sinus or chest until I see that their is a failure to respond.
If I have a less trustworthy patient as far as history of failure to return
for followup visits, I then xray too often.
Therefore I might miss the diagnosis but so far I have not injured a
patient by doing this as far as I know.

What I see as a problem in our present training programs is failure to have
 close supervision by a practicing physician, speaking to the student or
resident in training, addressing the difficulties in examining a patient
and assuring that one is doing no harm in either making the correct
diagnosis or treating appropriately. Along with this supervision, some
individual admission about one's experience making mistakes and how to
avoid these errors should be addressed.

I am looking forward to our visit in September.

Leonard Hoffman MD
Houston Texas

Clinical Professor Pediatrics University of Texas at Houston
Director of Pediatric Allergy Clinic 1972-1996







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