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The People's Pharmacy

Show 881: The Art of Diagnosis (Archive)

The People's Pharmacy

Joe and Terry Graedon

Medicine, Health & Fitness, Kids & Family, Alternative Health

4.61.2K Ratings

🗓️ 1 July 2015

⏱️ 58 minutes

🧾️ Download transcript

Summary

Diagnosis is the very foundation of medical care. Without an accurate diagnosis, doctors have no way of determining the appropriate treatment.

Decades ago, doctors used to rely heavily on the patient’s account of her problem (called the “history”) and the doctor’s direct physical examination of the patient. Medical students still learn these skills, but in practice many physicians order images without conducting a thorough physical exam. What factors are behind this trend? What are the consequences? We talk with Dr. Abraham Verghese about the art of diagnosis and how the process can sometimes go awry.

The Physical Exam:

The ritual of the physical exam also establishes the human connection between doctor and patient as one focused on healing, even when a cure is not possible. Has medicine become too focused on quantitative measures and standardization? Find out how over-reliance on high technology might be reversed and whether the culture of bedside medicine can be revived.

This Week’s Guest:

Abraham Verghese, MD, MACP, Senior Associate Chair and Professor for the Theory and Practice of Medicine at Stanford University School of Medicine. His books include My Own Country: A Doctor’s Story, The Tennis Partner and a novel, Cutting for Stone. Dr. Verghese is online http://www.abrahamverghese.com/

Learn more about the Stanford University Medical School program he leads at http://stanfordmedicine25.stanford.edu/
The photo of Dr. Verghese is by Sean Nolan.

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free.

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Transcript

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0:00.0

Hi, I'm Joe Graydon.

0:02.3

I'm Terry Graydon.

0:03.8

Welcome to this podcast of the People's Pharmacy, where we bring you the stories behind the health headlines.

0:10.2

This podcast is brought to you by Redux Industries, makers of utterly smooth body cream.

0:16.0

800-345-7339 on the web at utter cream.com.

0:31.2

High-tech tools dominate medicine, but are doctors missing basic information if they don't listen to, look at and touch the patient?

0:40.0

This is the People's Pharmacy with Terry and Joe Graydon.

0:50.5

Dr. Abraham Vergeese is on a crusade to restore the physical exam to its role in diagnosis.

0:57.2

When physicians order expensive images and pay more attention to the computer than the patient,

1:02.2

they risk losing the human connection.

1:04.4

Are the incentives in American medicine interfering with good care?

1:08.8

We are reimbursed in America generously for doing things to patients

1:13.1

as opposed to four patients.

1:15.1

Coming up on the People's Pharmacy,

1:17.0

find out what doctors could learn

1:18.6

from Sherlock Holmes

1:19.7

and why diagnosis might improve

1:21.9

when patients talk and doctors listen.

1:25.3

First, this news.

1:30.2

In the People's pharmacy health headlines, commonly prescribed antidepressants

1:35.5

called SSRIs are linked to fractures in older women.

1:40.1

These drugs have become popular to treat the menopausal symptoms of hot flashes and night sweats.

...

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