{"id":6189,"date":"2013-11-25T12:48:20","date_gmt":"2013-11-25T18:48:20","guid":{"rendered":"http:\/\/wholehealthchicago.com\/?p=5931"},"modified":"2022-03-21T14:59:04","modified_gmt":"2022-03-21T19:59:04","slug":"chilling-health-care-news","status":"publish","type":"post","link":"https:\/\/wholehealthchicago.com\/blog\/2013\/11\/25\/chilling-health-care-news","title":{"rendered":"Chilling Health Care News"},"content":{"rendered":"\n

It\u2019s tempting to begin this health tip with \u201cHere\u2019s the news from Lake Wobegone<\/a>\u2026\u201d You\u2019ll soon discover why as I tell you about two recent articles of note. Also, I\u2019d be most interested in your interpretation from a health care consumer\u2019s point of view.<\/p>\n\n\n\n

The first article, published this week in JAMA Internal Medicine<\/i><\/a>, reported the findings of an online volunteer group of 118 general internists who had agreed to participate in a unique study that tested both their diagnostic expertise and their self-confidence in that expertise. First, though, you need to know that physicians are regularly checked with test patients throughout their careers, usually as a prerequisite for recertification in their specialty. These tests can be quite complex, the physician starting out by reading the fictional patient\u2019s history, physical findings, lab tests, and x rays. The doc may even be shown photographs of his or her \u201cpatient.\u201d Then, using the old-fashioned multiple-choice format (but online), the physician chooses appropriate steps to manage this medical challenge, which will end either well or badly for the make-believe patient.<\/p>\n\n\n\n

Until now, though, no one has examined the degree of self-confidence among physicians as they go through this diagnostic testing.<\/p>\n\n\n\n

As a patient, ideally what you want is a doc who\u2019s a good diagnostician, who listens to you, orders appropriate tests, and is reasonably confident in what she\u2019s doing. But equally important, you want someone who, when confronted with a more complex diagnostic dilemma, is willing to say \u201cHmmm\u2026I\u2019m not sure\u201d and order the additional tests required to reach a diagnosis and\/or seek help from other sources, like a textbook, the internet, or another physician, either a colleague or by referring you to a specialist.<\/p>\n\n\n\n

If that\u2019s your kind of doctor, the article\u2019s results are not good news.<\/b><\/h3>\n\n\n\n

Researchers presented physicians with four imaginary patients, two with easy diagnoses and two with quite difficult ones. Here\u2019s a bullet-point list of results:<\/p>\n\n\n\n