Role of diagnosis in cutting waste in clinical care

Danny Long dannylong at EARTHLINK.NET
Fri Nov 7 03:05:11 UTC 2014

The question posed:  -> The key question is how do you (practically) make our current clinicians "skilled diagnosticians" (those that aren't already of course)?

I worked in a different field that required correct diagnosis for over 30 years.I propose not all providers are capable of being great at diagnosis.  It is the human condition that we all need to come to grips with.

1. Some have the inner workings to be great surgeons, 

2. Some will be great at accurately documenting patient history, and rooting out inaccuracies in the records to establish a solid base line.

3. Some will be great at bedside manner.. etc, (you get the gist)

BUT a Great diagnostician is a rare bird who likely is less than a great surgeon, or people (co-worker) skills, etc.

from  my experience:  I simply loved diagnosis of complex and often intermittent symptoms in an ever changing environment. I loved it, and loved sharing what I learned with others, mentoring others to the basics of diagnosis.

Truth is, there were many others who were/are much better skilled (internally) to perform the other tasks needed to correct the problem/symptoms after the diagnosis was reached, and double confirmed.

The ol'e saying "A great carpenter does not a cabinet maker make" still holds true, visa-versa too.Trying to be all to everyone is doomed to failure.

Diagnosis simply MUST be premised starting with the end in mind.  The end MUST be the patients condition after the medical intervention/care.

The willy-nilly half hazard charting, diagnosis anchoring, personal bias days simply must end if we are ever to end the post-harm patient harm falsifying and cover-ups.

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