Dr Davé's metaphor implies that Aunt Minnie (rapid diagnosis and precepting) requires experience, and we agree. We agree also that Socratic dialogue is an important part of medical training. We emphasize that our commentary was directed to the needs of patients and trainees in a busy pediatric office or outpatient clinic.
Training programs provide ample opportunity for Socratic dialogue: journal club, morning report, "curbside consults," and so on. But the leisurely, free-wheeling and stimulating discussions in these venues are usually not appropriate in the clinic. The most obvious problem is time. Neither patients nor other trainees like to be kept waiting during lengthy preceptor-trainee dialogues. This is especially true when some time must be allocated to teaching examination techniques and validating the findings.
Cunningham AS, Blatt SD, Fuller PG, Weinberger HL. Socrates or Aunt Minnie?—Reply. Arch Pediatr Adolesc Med. 1999;153(8):893. doi: