Building a Reliable and Affordable System of Medical Care
In this critical review of our approach to medical education, medical practice and decision-making in medicine, the authors draw upon the disciplined thinking of Francis Bacon (mid 1600s), Battista Morgagni (late 1700s), and others to advocate for recognition of the limitations of the human mind as applied in the way medical learning is imparted and the way physicians practice. The authors outline how medical students acquire scientific knowledge, but not scientific behaviors. A scientific approach to diagnosis begins with using information tools to identify all diagnostic possibilities for the presenting problem and the initial findings needed to determine which possibilities are worth investigating in the patient. If the initial findings do not reveal a clear diagnostic solution, then information tools must be employed as part of a system of care to enforce highly organized follow-up processes, that is, careful problem definition, planning, execution, feedback, and corrective action over time, all documented under strict standards of care for managing the complexities involved.
KeywordsIntellectual behaviors of modern science Transforming medical education Fallacies in medical decision-making Medical error/diagnostic failures Clinical decision-making technology Knowledge development system Individualized healthcare delivery Patient’s problem oriented medical record
The authors wish to acknowledge Chris Weed’s assistance in the planning and preparation of this paper and to thank him for all his support in his editorial reviews of the manuscript.
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