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April 15, 1974

The Effective Clinician: His Methods and Approach to Diagnosis and Care

Author Affiliations

Tulane University School of Medicine New Orleans

JAMA. 1974;228(3):401. doi:10.1001/jama.1974.03230280101049

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Using pictures of famous physicians as illustrations, Dr. Tumulty tells his readers how to manage their patients and, when necesssary, the patients' families. Tumulty finds it difficult to understand how a computer or a physician's assistant can obtain a satisfactory medical history. Nothing, he writes, so manifestly demonstrates the qualities of a good physician to the patient (and gains the patient's confidence) as a meticulously accomplished history and physical examination.

According to Tumulty, the most common cause for inaccurate diagnosis is allowing inadequate time for obtaining and analyzing clinical data. He describes his systematic, step-by-step approach to differential diagnosis and applies it to the illnesses of different patients. First, he gathers all the clinical evidence; next, he organizes the evidence in brief outline form; then, he selects from the outline one or more key features; and finally, he lists the various disorders capable of producing these key features and chooses