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The question raised by Dr Bosley is far too complex to be answered in this brief response. I will make one observation, however. The fact that I think that I can diagnose many cases of otitis media does not prove my competence as a pediatrician. A physician's ability to measure heart size does not mean that he is adequately evaluating the chest film. I recall the case of the cardiologist who ordered a chest film for his patient with chest pain. He was able to measure the heart size but he did not notice the metastatic lesion in the rib. The familiarity that a specialist may have with his area of expertise is not sufficient to guarantee adequate interpretation of all the other organs imaged on the radiograph.
Homer MJ. Role of the Radiologist-Reply. JAMA. 1982;247(16):2233. doi:10.1001/jama.1982.03320410019015
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