Intended for healthcare professionals


The changing doctor-patient relationship

BMJ 2000; 320 doi: (Published 25 March 2000) Cite this as: BMJ 2000;320:873

Diagnoses are made from careful history and examination

  1. Vincent McAulay (, research fellow.
  1. Royal Infirmary of Edinburgh, Edinburgh EH3 9YW
  2. PKC Corporation, Chace Mill, Box A-8, One Mill Street, Burlington, VT 05401, USA
  3. Groom Law Group, Chartered, 1701 Pennsylvania Avenue NW, Washington, DC 20006, USA

    EDITOR—I welcome the improved use of resources already available to us, but I must point out some facts to Weed and Weed.1 When we are medical students we are taught that more than 80% of diagnoses can be made on the basis of a careful history and physical examination. We are therefore taught to focus on individual symptoms and signs from which a differential diagnosis is formed and appropriate investigations are requested. I was certainly not taught to “focus on general knowledge about large populations.” Doctors in the United Kingdom undertake a period of general professional training and have to complete a difficult and highly competitive examination, before specialisation. The Weeds' case was from the United States, and many specialists were involved in the patient's care, which …

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