Diagnosis; Still Our Achilles Heel?

[摘要] This is my first Editor’s briefing since joiningthe BJGP as Associate Editor and it is apleasure to introduce our theme of diagnosis,such an important part of our role as GPs, andyet an area which has been argued is also our‘Achilles heel’.It was 50 years ago that John Howie,Emeritus Professor of General Practice at theUniversity of Edinburgh, published ‘Diagnosis— the Achilles heel?’1 He argued that thedecision to prescribe for a set of symptomsfrequently preceded the allocation of adiagnostic label, that is, the diagnosis followedthe prescription. In his brilliant follow-up piece‘After Achilles’2 6 years ago, former Editorof this Journal and esteemed colleagueProfessor Roger Jones, argued that ‘generalpractice has floundered among unhelpfulphrases such as “tolerating uncertainty”,“using time as a diagnostic tool” and “lettingthe diagnosis emerge” … this approach todiagnosis is sloppy and idle’, while calling fora paradigm shift in our approach to diagnosis.

[学科分类] 卫生学