July 25, 1994

Clinical Judgment Is Essential-Reply

Author Affiliations

Toledo, Ohio

Arch Intern Med. 1994;154(14):1643. doi:10.1001/archinte.1994.00420140115015

I agree with Romano's insightful observations. There are many problems with Monday morning quarterbacking. We need to be cognizant of the fact that it is easy to be accurate in the diagnostic process if one is reviewing a case after the fact with complete laboratory and autopsy reports. It is easy to do morning report with students and residents when you have all the answers neatly summed up while the students and residents have been up all night on the front line with patients.

Legal and medical professionals may appear brilliant if they know the answer in advance; however, if they were presented with the case without the answer, they might also be baffled. My article1 emphasized such an issue in the diagnosis of pulmonary embolism. We need to develop greater humility about the diagnostic process and put ourselves in the shoes of our colleagues who must make difficult diagnoses

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