The Attrition of Diagnostic Skills

Since the late sixties, medical technology has jumped ahead by eons, the same as most technology has in recent years.

In the late sixties and early seventies we did not have mammography, ultrasound, CT’s, MRI’s, PET scans or da Vinci robotic surgical procedures. What we did have were well trained physicians that could diagnose and treat without the myriad of tests now available. It has become much easier to grab a palm pilot and order multiple tests and let the radiologist or other specialist make the diagnosis. There has been a huge attrition in diagnostic skills of the physician today. The people that are in general medicine now, the family practitioner, function at approximately the same level as a physician’s assistant or a nurse practitioner.

How does this happen? Family practitioners are capable of doing much more in their medical specialties than they currently do. They are however severely limited by the restrictions specialists place on them. This may be not so much a case of specialists protecting their own “turf”, but rather of not looking at what the capabilities of the family practitioner. And if a family practitioner is not given privileges based on their capabilities why make medical school and all its branches necessary to practice a specialty at all? If someone is going to look at only a hand, a nose, mouth or throat for the rest of their career, why not start them out in their specialty training at age 18, 19 or twenty? After all, other than gaining social skills, is college and medical school really a necessity. Couldn’t we just have a hand or nose surgeon to put a whole damaged hand or nose back together again?

Just think we could have our own 38 year old Doogie Howser, MD., with twenty years of experience rather than the 38 year old specialists we have today that may have four or five years of experience.