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September 6, 1985

Delaying the Diagnosis of Disease

Author Affiliations

St Vincent Hospital University of Massachusetts Medical School Worcester

JAMA. 1985;254(9):1176. doi:10.1001/jama.1985.03360090066021

To the Editor.—  Howard Spiros1 COMMENTARY entitled "Delayed Diagnosis of Disease," is, predictably, a muchneeded contribution to reasoned thinking. Apart from emergency conditions, there are relatively few situations where unusual speed (not to say haste) is justified if a patient is not suffering. Indeed, treatment of significant symptoms should only be delayed if it would interfere with subsequent diagnosis. Moreover, there are numerous situations where knowing the name of the disorder or its pathogenesis has little bearing on how it is handled. Indeed, physicians intuitively understand all this, since, except for our own proportion of anxious colleagues, we are notorious for showing up late in the game after first trying to self-medicate our symptoms. The main reason is that such attempts usually are successful. Why not extend the same grace to the patient, saving him inconvenience and expense, as long as we do not impair his prognosis? Naturally, in