Intended for healthcare professionals

Rapid response to:

Practice Diagnosis in General Practice

When no diagnostic label is applied

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2683 (Published 25 May 2010) Cite this as: BMJ 2010;340:c2683

Rapid Response:

Lack of diagnosis and working environment

I read your article and found it very insightful. As a student soon
to commence a medical degree, I've very interested in the practical
aspects of patient management. And as a student who has also worked in
customer service prior to studying, I think to an extent I can relate to
some of the pressures doctors face from pushy members of the public who
are 'self-schooled' in medicine through widening access to information in
the form of the Internet. It's reassuring to see that this was acknowledged in your
article.

Another point that I wonder that you might be able to clarify for me:
although I haven't shadowed any primary care doctors during my time
preparing for my medical application, I'm well aware of the current target
-based system where medics (GPs specifically, I'm told) are required to
perform to a fast turn-around time, and I wonder whether, in the
experience of the authors, this is a contributary factor to lack of
diagnostic label in some cases? This is not to suggest that I believe that
today's medics are flippant towards their patient's problems but quite the
opposite - that they have so little contact time for their patients in
line with the length of appointments given and high workloads, etc. that
it may be more responsible to refrain from giving a diagnosis due to lack
of time to fully explore the problem, than to give a potential
misdiagnosis?

I wonder whether, in the author's experience, this factor does
contribute (both in primary and secondary investigations)to lack of
diagnostic labelling and if so, in what ways to today's medics try to get
around this?

Please forgive any ignorance of this topic that shines through in my
question: like I said, I have limited experience in the field of medicine
thus far to match my curiosity :)

Competing interests:
None declared

Competing interests: No competing interests

27 May 2010
Katie Percival
Sports Science graduate, soon to be medical undergraduate
Leeds Metropolitan University