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Research Letter
Aug 8 2011

Invited Commentary—Medical Technology—Still an Adjunct to Clinical Skills in Making a Diagnosis

Author Affiliations

Author Affiliation: Department of Medicine (Emeritus Professor of Medicine), University of California, San Francisco.

Arch Intern Med. 2011;171(15):1394-1400. doi:10.1001/archinternmed.2011.339

The main responsibility of the physician to a patient is to make an accurate diagnosis so that appropriate treatment can be instigated. For centuries the physician had only the history and physical examination as the instruments to use in making a diagnosis of the patient's illness. Gradually, basic laboratory tests were added, and at the beginning of the 20th century, radiography and later electrocardiography were developed. Most patients with symptoms sufficient for them to appear in an emergency department (ED) have a wide variety of illnesses, many of which are readily diagnosed without sophisticated imaging techniques. So how important in arriving at a correct diagnosis are these modern (and expensive) imaging devices for the usual spectrum of diseases seen in the ED?