My most useful surgery instrument

BMJ 2004; 328 doi: (Published 11 March 2004) Cite this as: BMJ 2004;328:630
  1. Paul Vincent, general practitioner and trainer
  1. Birtley Medical Centre, County Durham

    What could it be that really makes a difference among the clutter of my room? Perhaps the clichéd badge of medical authority, the stethoscope? No, on reflection, I think not: “Mr chesty cough aged more than 60” will receive an antibiotic whatever I hear, and little “Miss croupy cough but well” will not, even if I do hear the odd crackle on a lung base. Perhaps it is the sphygmomanometer: think of all those strokes saved by judicious use of bendrofluazide. Yet again, perhaps not: “Mr ischaemic heart diseases on three antihypertensives at full dose” will have high blood pressure whatever I throw at his cardiovascular system. Perhaps then, …

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