‘Differential diagnosis? Hell, they use the CT to do the physical exam!’

A veteran emergency-medicine specialist is urging his peers to appreciate the wonders of modern medical imaging without losing sight of all that’s right about hands-on care.

“In EMS, we have few sophisticated tools to rely on,” writes Neal Richmond, MD, in the Journal of Emergency Medical Services. “Instead, we have to depend on our eyes, ears, hands and even our sense of smell. That’s not a bad thing because, like clinicians of old, we’re forced to develop and use highly tuned senses.”


“Instead of sending patients to radiology, we examine them more closely, seeing if a couple doses of nitro actually improve their shortness of breath, thereby narrowing our differential diagnosis in the act of treating them. … At the risk of sounding like a country preacher, there’s also the untold benefit of ‘laying on of hands.’ Touching sick or worried patients may even have its own therapeutic benefits.”

Richmond is medical director of MedStar Mobile Healthcare in Fort Worth, Texas. Read the whole thing: