H&P

Methinks Dr. Brewer over at the Wall Street Journal makes several important points today:

Patients present their doctors with undifferentiated problems, such as fever or trouble sleeping. Sometimes a common disease like a sore throat will present in a striking way. Or worse, a serious problem like lung cancer will present with a common symptom like a stubborn cough.

There's a steep penalty for being mistaken, however. An uncertain diagnosis often leads to expensive defensive medicine in the form of extra X-rays and lab tests. Tests like those can be a crutch. In my experience, they don't always help with diagnosis as much as a thorough medical history or physical exam.

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