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October 20, 1989

Essays on the Rise and Decline of Bedside Medicine

JAMA. 1989;262(15):2158-2159. doi:10.1001/jama.1989.03430150126044

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It is generally agreed that doctors now spend less time with their patients than in the past. The single author of this collection of essays addresses this issue by noting that the information explosion of the 20th century, coupled with the increasing threat of litigation, has placed pressure on physicians to choose between the "bedside" and the "lab." Clearly, he thinks they have made the wrong choice and his dismay over the exaggerated importance of the lab has inspired him to write.

Insights offered by senior members of the profession can provide valuable clinical philosophy. The author, who has made a number of contributions to pathophysiology, claims that the strongest critics of laboratory medicine are those who have mastered and rejected it. A "strong critic" himself, then, he is no stranger to the telling of cautionary tales. Like a latter-day Cassandra, in a series of recent columns for Chest he