Ten Principles for More Conservative, Care-Full Diagnosis
Authors: James L. Meisel
Journal: Annals of Internal Medicine (2019)

Letters4 June 2019Ten Principles for More Conservative, Care-Full DiagnosisJames L. Meisel, MD, MHPEJames L. Meisel, MD, MHPEBoston University School of Medicine, Boston, Massachusetts (J.L.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0148 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Schiff and colleagues' commentary (1) is much more than a perspective piece. As intended, the authors not only incorporate principles of decreasing diagnostic harm but also highlight the dearth of time to accomplish what matters to patients and caregivers (2, 3); the need for clinical reasoning to precede diagnostic testing; and the central roles that continuity, humility, and trust play if care is to be focused on the person (4) rather than on a particular symptom, diagnosis, or laboratory test. I believe that it should be considered a landmark publication, to be actively taught and broadly reflected ...Reference1. Schiff GD, Martin SA, Eidelman DH, Volk LA, Ruan E, Cassel C, et al. Ten principles for more conservative, care-full diagnosis. Ann Intern Med. 2018;169:643-5. [PMID: 30285046]. doi:10.7326/M18-1468 LinkGoogle Scholar2. Ludmerer KM. Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care. New York: Oxford Univ Pr; 1999. Google Scholar3. Internal medicine interns spend only 13% of workday on direct patient care. ACP Internist Weekly. 23 April 2019. Accessed at www.acpinternist.org/weekly/archives/2019/04/23/5.htm on 2 May 2019. Google Scholar4. Starfield B. Is patient-centered care the same as person-focused care? Perm J. 2011;15:63-9. [PMID: 21841928] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Boston University School of Medicine, Boston, Massachusetts (J.L.M.)Disclaimer: The views expressed in this article are those of the author and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the U.S. government.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0148. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTen Principles for More Conservative, Care-Full Diagnosis Gordon D. Schiff , Stephen A. Martin , David H. Eidelman , Lynn A. Volk , Elise Ruan , Christine Cassel , William Galanter , Mark Johnson , Annemarie Jutel , Kurt Kroenke , Bruce L. Lambert , Joel Lexchin , Sara Myers , Alexa Miller , Stuart Mushlin , Lisa Sanders , and Aziz Sheikh Ten Principles for More Conservative, Care-Full Diagnosis Gordon D. Schiff , Kurt Kroenke , Bruce L. Lambert , Lisa Sanders , and Aziz Sheikh Ten Principles for More Conservative, Care-Full Diagnosis Katherine Rediger and Bailey Miles Ten Principles for More Conservative, Care-Full Diagnosis Thierry Pelaccia Metrics 4 June 2019Volume 170, Issue 11Page: 823KeywordsCaregiversDisclosureGraduate medical educationLaboratory testsReasoningUndergraduates ePublished: 4 June 2019 Issue Published: 4 June 2019 PDF downloadLoading ...