In describing a visit to this country, Dr. Rolleston1 expresses himself interestingly as to medical teaching and hospitals here. He says that more systematic work is done in the clinical laboratories, but that there is a serious lack of routine ward work in the hospitals. The danger is suggested that the thoroughness in the clinical laboratory examinations may lead to less thoroughness in the routine physical examination of patients. (Specialism is more extreme, he states, than abroad.) I believe that this criticism is fair and just. The not infrequent diagnostic errors of internists and surgeons, even those who have had good educational and clinical advantages, show a lack of thoroughness in examinations and of close observation of clinical phenomena, or at least failure to deduce rational conclusions.
The schools, and the bearing of many leading men in special work, in emphasizing, to an inordinate degree, the importance of pathology and
GRANT WW. DIAGNOSIS IN ITS RELATION TO THE LABORATORY AND THE BEDSIDE. JAMA. 1909;LII(10):745–746. doi:10.1001/jama.1909.25420360001001
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