Paul E. Epstein, MD
Technologic advances in medicine have been both boon and burden to physicians, patients, and health care planners. In an era of explosive health care costs, a major challenge is to improve diagnostic accuracy while controlling expenditures. However, for the generations of physicians who were weaned on Osler's exhortation to "diagnose, diagnose, diagnose," the need to practice diagnostic restraint is a bitter pill indeed. Yet, in the 1990s, the final marginal increase in diagnostic accuracy comes at an extraordinarily high monetary cost. To budget our medical resources responsibly, we must be increasingly ingenious in approaching test utilization and increasingly analytic in
Paul E. Epstein. Cassandra and the Clinician: Are Clinical Prediction Rules Changing the Practice of Medicine?. Ann Intern Med. 1990;113:646–647. doi: 10.7326/0003-4819-113-9-646
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Published: Ann Intern Med. 1990;113(9):646-647.
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