The lost art of medical diagnosis

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University of Miami pediatrician Judith L. Schaechter, M.D. (L) gives a vaccination to a 13-year-old girl in her office at the Miller School of Medicine on September 21, 2011 in Miami, Florida.
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When was the last time you had an extensive, hands-on, physical exam in the doctor's office? With a push for technology and hyper-specialization in the medical world, many fear that the art of general diagnosis and the teaching of good diagnostic practices may be fading.

Lisa Sanders, physician and author of the New York Times Diagnosis column, compared today's doctors to Click and Clack on NPR's Car Talk show, who take phone calls about listener car problems.

"We ask people to report to us how their bodies are working," she said. "We can't open the hood and check out the carburetor - we can do tests that support our hypothesis, but it comes down to communication."

Sanders will join The Daily Circuit Wednesday to discuss how to revive the lost art of the diagnosis and why getting back to basics at the doctor's office could lead to more affordable healthcare.

"In most things as you rise you become less specialized; only in medicine are narrow focuses valued more highly," she said. "The CEO at a business cannot be the CEO of one thing, they have to be the CEO of the entire company, but in medicine the generalist is valued the least."

John Kugler, internist at Stanford Medical Center and a founder of the Stanford 25 Initiative in Bedside Medicine, will also join the discussion. The Stanford 25 works to improve doctor's bedside manner and skill.

"One of the biggest things we worry about is the loss of the physician and patient relationship," he said. "You'll talk to a patient and they'll tell you about visits to the doctor and they'll say that the doctor hasn't touched them in years. That really breaks down the feeling of trust that is necessary to form a therapeutic relationship."

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