Trefor Roscoe 5-8-96 wrote in response to my promotion
of patient centred medicine
>Does he thus imply that patient centered medicine involves doing uneccessary
>investigations to reassure the patient of their normality? Doctor centered
>medicine may be inappropriate, but not investigatiing unless you are
>investigating for a particular purpose with a range of diagnostic or
>treatment options in mind, which will be altered by the results of the test,
>is IMHO good clinical practice, in the UK or anywhere else.
What investigations we do (including clinical examination) depend
on the probability of an abnormal result and fear of the consequences
of being wrong. This is in part cultural because nowadays a doctor
is unlikely to be forgiven for missing serious disease. I frequently
ask myself why medical colleagues and their relatives get more thoroughly
investigated. It is not just zeal. It is recognising that even long
odds sometimes come up and the scope for criticism is greater. Why do we
not investigate all our patients as thoroughly? Rationalisations
on a postcard please to................
Doug Jenkinson, Keyworth, Nottingham
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