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Letters |15 May 2018

Diagnostic Reasoning

David M. Mitchell, MD, PhD

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TO THE EDITOR:
As a former hospital medicine inpatient teaching attending and a hospitalist with 15 years of experience in several states, groups, and hospital sizes, I agree with Simpkin and colleagues (1) that the practice of diagnostic reasoning is sadly fading quickly in inpatient medicine. However, I believe that education is not the sole problem or the final solution. Financial and time-related pressures are turning even well-trained “thinking” residents into inpatient triage robots unfortunately retrained to stop thinking and instead focus on generating more revenue, building higher case-mix indices, and producing higher patient satisfaction and quality scores...
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Mitchell DM. Diagnostic Reasoning. Ann Intern Med. 2018;168:750. doi: 10.7326/L18-0010

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Published: Ann Intern Med. 2018;168(10):750.

DOI: 10.7326/L18-0010

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2018 American College of Physicians
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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