BMJ  2006;333:134-135 (15 July), doi:10.1136/bmj.333.7559.134-a

Commentary

Wide angle thinking helps patients with distressing illness

¹ Institute of Clinical Education, Warwick Medical School, University of Warwick, Coventry CV4 7AL ed.peile@warwick.ac.uk

The first 150 words of the full text of this article appear below.

Kenneth Neville presents interesting problems for specialists and generalists alike.¹ At the time of the case presentation, we were told about a young man with distressing symptoms of postprandial vomiting leading to weight loss and weakness. The local hospital had diagnosed gastro-oesophageal reflux disease, and a battery of other routine investigations had given negative results. We were presented with several possibly relevant psychological factors, and it was mentioned that his asthma had been difficult to control. Readers were invited to consider the differential diagnosis and to suggest the most helpful course of management for the family doctor to take when Kenneth re-presented shortly before Christmas.

Doctors need to look at all angles Credit: DAVID PARKER/SPL

 

How often have I heard the expression, "This patient has been fully investigated at...?" The truth is that no patient is fully investigated. Investigation, like diagnosis, is a means to an end, and the end . . . [Full text of this article]

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