Dear lists
Clinicians don't always (/often?) proceed from symptoms to
examination to diagnosis to treatment in a linear fashion.
Consider depression in general practice. If the GP only has
tricyclics as his available treatment option, he may refrain from
making the diagnosis at all if he believes that the patient will not
tolerate their adverse effects ( e.g.a patient with cardiac
problems).
The advent of SSRIs has expanded the available treatment options, and
diagnoses of depression ( or at any rate, prescriptions of
antidepressants ) have risen. It seems that GPs may identify patients
as a "case of Prozac", and
then move from the possible treatment back to eliciting the
diagnosis.
Has anyone any references to this "non-linear" diagnostic process?
NB this is not meant as an adverse criticism of GPs.
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