We are immersed in a world of technology—robotic surgery, genetic manipulation, molecular biology, et cetera.
Yet, my plea is simple and direct: Do not forget the basics of physical examination, for many times, they more quickly and efficiently lead to the clinical diagnosis than the newer diagnostic modalities.
Labor day is over, and the dog days of summer are quickly coming to an end. I know this because the shadows are getting longer, the days are ending a bit earlier each week, and the whining about the end of lazy summer days has begun. And I know THIS because I am one of the loudest of those whiners… summer’s end gets me every year.
But it’s important to remember that the heat and humidity are still very much with us. Summer carries well into September, and even October can have some severe humid days. This past week alone has been some of the hottest days I’ve experienced outside. The sun is waning but it’s still very important to continue to take those sun precautions, and protect yourself internally and externally from the strong sun as we are out and about exercising and enjoying our outdoor activities.
We used to be critical of labeling patients with their disease. Now it is getting worse: instead of referring to specific patient issues, we tag “cases” with standardized CPT coding numbers. It seems like “The System” is winning.
When lecturing on the basics of radiological anatomy to first year medical students, I always start out by projecting a PA chest radiograph and asking the class, “What do you see?” Hands go up and the bright-eyed, eager medical students shout out that they see “a chest x-ray.” That is exactly what all of them say; they see a chest x-ray.
In my earlier entry, I wrote about common errors made by test-takers. Probably the most common error made by the test-taker is that he or she hurriedly reads the stem without careful attention to all details.
Many radiology textbooks teach imaging technology and the abnormalities found on medical images. Most of those abnormalities or “findings” will never be seen (or require interpretation) by the majority of clinicians throughout a long career. The basics of radiology imaging and interpretation are important, but there is much more stuff beyond a collection of radiological findings to make a textbook useful for medical professionals who have no intention to specialize in radiology.
Even in these times in which The System reigns supreme, some of us stll believe that what we do for the patient is the only thing that really matters. Being able to identify unusual radiographic findings or “signs” may be good for self esteem, but that does not guarantee that the patient will benefit.