A front-page story in today's Science Times poses a provocative question in the rapidly changing world of medical diagnostics: Can computer software ever replace physicians to ensure timely, correct diagnoses?
With his answers, Dhaliwal displays his encyclopedic fund of knowledge as well as "his entire thought process...with the goal of 'elevating the stature of thinking, ...[B]ecause in medicine,' Dr. Dhaliwal said, 'thinking is our most important procedure...Getting better at diagnosis is as important to patient quality and safety as reducing medication errors, or eliminating wrong site surgery.'"
How does Dhaliwal do it? For starters, he has developed a strong knowledge base. Obviously, doctors cannot diagnose a problem with which they are unfamiliar. Given the explosion of published case reports and research findings, a strong knowledge base can be achieved only through never-ending intensive study.
But knowledge, alone, is never enough. Diagnostic acumen also depends on human intuition, the ability of a human subconscious that "sifts the wheat from the chaff....[P]hysicians must combine logic and knowledge with their pattern-matching instincts."
Here's the key message of both this article and Jerome Groopman's How Doctors Think: Thinking is key to quality medicine.
To optimize modern medical care, we must value physicians' thinking by (1) ensuring physicians have time to think and (2) reimbursing their time and effort.