Published 11 November 2009, doi:10.1136/bmj.b4418
Cite this as: BMJ 2009;339:b4418

Practice

Diagnosis in General Practice

Self diagnosis

Clare Goyder, academic foundation year 2 in general practice 1, Ann McPherson, university lecturer, medical director2, Paul Glasziou, professor of evidence based medicine1

1 Department of Primary Health Care, University of Oxford, Oxford OX3 7LF, 2 Health Experiences Research Group (formerly DIPEx), Department of Primary Care, University of Oxford, Oxford OX3 7LF

Correspondence to: Clare Goyder cgoyder@doctors.org.uk

Some conditions can be diagnosed correctly by the patient, but self diagnosis should always undergo challenge and refinement by the general practitioner

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

A 26 year old postgraduate student presents with a 12 hour history of a painful left eye. She feels her vision is reduced and her eye is watering more than usual. She has had a previous episode of iritis (anterior uveitis) and she suspects that this is the diagnosis today.

The process of diagnosis is pivotal to the daily work of the general practitioner. Despite the clinical importance of this process, many of the diagnostic methods used by GPs have been elucidated only recently. Three key stages in diagnostic reasoning have been identified (fig 1Go).1 In the first stage diagnostic hypotheses are triggered, and sometimes this is done by the patient: "Doctor, I think I have the flu/gout/tonsillitis/etc."


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  		Diagnostic stages and strategies

 
Several processes can initiate diagnostic hypotheses (fig 1Go). The most common is the patient presenting with a particular key symptom. The "presenting complaint" is used in . . . [Full text of this article]


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