|
TELL ME WHERE IT HURTS: THE SCIENCE AND ART OF MEDICAL DIAGNOSIS |
|||
| Overview | |||
|
Although rapid advances in medical science and new therapies often make front-page news, the age-old art of medical diagnosis serves as the foundation of medicine. The expert diagnostician can interview the patient, perform a physical, interpret laboratory results, and then synthesize this knowledge—which can be contradictory in nature—to make a logical analysis of the patient’s problem. But logic alone is not always enough in making a correct diagnosis. For example, during the doctor-patient interview, the physician is not merely recording the facts like Joe Friday of Dragnet fame. Rather, he or she takes the Columbo approach—making note of voice inflections, facial expression, and attitude, all of which can reveal more than what is learned from oral responses alone. In the end, the physician must rely on a combination of his or her medical knowledge, intuition, and judgment. A number of modern diagnostic technologies are also available to assist in medical diagnosis. When German physicist Wilhelm Conrad Roentgen produced the first x-ray of the human body (his wife’s hand) in 1895, the medical community had its first tool for a noninvasive look inside the body. Today’s diagnostic imaging techniques, like computed tomography and magnetic resonance imaging, can reveal the miraculous details of the patient’s anatomy and physiology. The physician also uses tools like electrocardiograms and blood-gas to measure and interpret important physiological functions. Even computerized expert systems that mimic the human decision-making process are available to help the physician in diagnosing difficult or unusual cases. In “Tell Me Where It Hurts: The Science and Art of Medical Diagnosis,” mini-med students will learn about the many-faceted approach to modern medical diagnosis, from the physicians’ bedside rapport to the importance of new technology and tests. In the final analysis, the physician who masters the art of diagnosis has an ideal physician-patient relationship, one that is based on a thorough knowledge of the patient—and on mutual trust. |
|||
|
Associate Professor of Medicine and Psychiatry |
|
||
|
Throughout
his career, Dr. Arnold has been a practicing physician with a strong interest in
medical ethics and the doctor-patient relationship.
He joined the School of Medicine faculty in 1988 and is director of
the school’s Clinical Ethics Training Program and Fellowship in Medical
Ethics. Since 1997, he has been a
Project on Death in America Faculty Scholar—a Soros Foundation effort to
create academic role models, leaders, and mentors for future health
professionals. In this capacity, Dr. Arnold is the principal investigator of a
project teaching physician “change-agents” to communicate with terminally
ill patients about psychosocial and ethical aspects of care.
Dr. Arnold has received numerous awards and recognition for his
outstanding efforts in medicine and medical ethics, including being named an
“Outstanding Young Man in America” (1985) and a “Medicine’s Rising
Star” (1988) by the American Medical Student Association. He is listed in Who’s
Who among Young Americans (1992), Who’s
Who in Medicine and Healthcare (1995-1996), and Who’s Who in the World (1997).
Dr. Arnold received both his B.A. in biology and philosophy and his M.D.
from the University of Missouri in 1983. |
|||
|
Professor of Radiology
|
|
||
| In addition to being board-certified in internal medicine, Dr. Wright is chief of the Division of Rheumatology and Clinical Immunology; director of the University of Pittsburgh Arthritis Institute; and director of the UPMC Arthritis Network. He received his B.A. from the University of Delaware and his M.D. from Johns Hopkins University School of Medicine. Following his internship and residency in internal medicine at the Medical College of Virginia, he completed postdoctoral fellowships in both the Division of Rheumatology and the Department of Molecular Biology and Genetics at Johns Hopkins University School of Medicine. His clinical interests focus on systemic sclerosis and other autoimmune connective tissue diseases, and his research interests are studying the basic mechanisms of systemic sclerosis, systemic lupus erythematosus, and other autoimmune rheumatic diseases; molecular immunology; transcriptional regulation; cytokine biology; and the genetics of autoimmune diseases. | |||
|
Dr.
Koop's Community: http://www.drkoop.com/
(provides health and medical information) MRI Tutor: http://128.227.164.224/mritutor/index.html (focuses on magnetic resonance imaging starting with the very basics) The X-Ray Files: http://www.radiology.co.uk/xrayfile/
(provides a large collection of radiology case material and tutorials
with good graphic images for education and enjoyment) |
|||
|
The
Art and Science of Bedside Diagnosis. Joseph
D. Sapira. (Baltimore, Urban &
Schwarzenberg, 1990) Harrison’s
Principles of Internal Medicine. Anthony
S. Fauci, et al., eds. (New York:
Mcgraw-Hill, Health Professions Division, 1998) The
Medical Interview: A Primer for
Students of the Art. J. L.
Coulehan. (Philadelphia: Davis,
1987) Radiology: An Illustrated
History. Ronald
L. Eisenberg. (St. Louis, Mosby
Year Book, 1992) Scientific American Medicine on CD-Rom (SAM-CDŽ). David C. Dale and Daniel D. Federman, eds. (one-year subscription; updated quarterly) |
|||
