Many readers know that I love mystery novels and TV shows. Recently I was talking with a third-year student, and realized that one of the reasons I love internal medicine is that every day I am a detective. As I watch detective shows and movies and as I read or listen to detective novels I am learning lessons about being a better diagnostician.
The best detectives collect data prior to coming to conclusions. They avoid premature closure. As they look at the evidence they do not act on the obvious, but rather ask about missing data. They refuse to rush to judgment.
The best detectives interview “persons of interest” during their investigation, but when they find more evidence (using from the CSI group) they resume their interviews, asking new questions, building on the scientific evidence.
The best detectives use mind play to consider possibilities. They tell a story (either out loud, or in their minds) and in the telling test that story for inconsistent data.
The best detectives obsess, not willing to give up on finding the answer. They keep searching until the answer becomes crystal clear.
Could you substitute “the best internists” in the above paragraphs?
db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.