IMreasoning - Clinical reasoning for Doctors and Students

What is compassion fatigue? Can you learn how to be more compassionate with your patients? We talk to Dr. Tony Fernando, psychiatrist, sleep specialist, educator and researcher, about compassion in healthcare, happiness, mindfulness, enlightenment, buddhist monks, and a bunch of other stuff. Enjoy!

We bring you our second attempt at "stump the chumps".  Our friend and colleague Oliver Menzies brought an interesting case.  We think this case was not quite as enigmatic as our first one (episode 5) but we hope it illustrates sound clinical reasoning as we work our way through the clinical information.  Enjoy.

When we talk about medical errors, we need to remember that there are two victims; the patient who suffers harm as a result of the error, and the clinician who makes the error.  As long as the practice of medicine remains a human endeavour, medical errors are inevitable.  As a medical community we need to accept that errors will occur.  We need to talk about them openly and honestly, share our own stories, and support our colleagues when they share their stories with us. As members of society, we should better understand the fallibility of medical practitioners, and we need to understand the limits of their craft. We had the opportunity to interview Brian Goldman, an ED doctor from Toronto, Canada, who is also a journalist, host of the CBC radio show "White Coat, Black Art", author of two books unveiling the secrets of medical culture, and a "TED-talker" with his presentation entitled "Doctors make mistakes - can we talk about that". We also interviewed our friend and colleague, Dr. David Spriggs, a Brit who has lived in NZ for many years, an excellent general internist and geriatrician, who regularly teaches our trainees on the reality of making mistakes.

The future is coming.  In this episode we talk to Shantanu Nundy of the Human Diagnosis Project (HumanDx).  As Shantanu describes it, HumanDx is a worldwide effort to map any health problem to its possible diagnoses.  We have come across various projects that aim to create that elusive, high-fidelity, real-life, artificial intelligence of diagnosis.  HumanDx is building that AI by connecting the knowledge, experience, and real-life cases from all of us.  This is OUR project.  We think that HumanDx is the real thing.  Enjoy!

The Diagnostic Error in Medicine Conference 2015 has finally come!  We have been looking forward to attending this conference for a while now.  This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm.  These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard. Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

The Diagnostic Error in Medicine Conference 2015 has finally come!  We have been looking forward to attending this conference for a while now.  This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm.  These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard. Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

The podcast covers insights from the Diagnostic Error in Medicine Conference, including humorous tales from speakers that set a lively tone. It discusses the effective use of checklists to enhance diagnostic accuracy and the importance of patient engagement. Emotional well-being of healthcare providers is emphasized, linking it to better patient care. The need for a patient-centered approach to diagnosing errors is explored, alongside a novel educational initiative aimed at reducing diagnostic mistakes in clinical practice.

Join the hosts as they dive into a challenging diagnostic case featuring a young male patient. They work collaboratively to unravel symptoms, prioritizing diagnoses based on medical history. The discussion also explores complex presentations like hepatomegaly and the importance of thorough clinical examinations. They engage in friendly bets on diagnoses, especially tackling rheumatologic conditions and adult-onset Still's disease. It’s a lively session full of insightful clinical reasoning and playful banter!

Gurpreet Dhaliwal is a Professor of Clinical Medicine at UCSF, celebrated for his insights into clinical reasoning. He delves into the complexities of diagnostic bias, emphasizing the importance of challenging assumptions and learning from past mistakes. The conversation also touches on the potential of computer-aided diagnosis and the necessity for high-quality data. Additionally, Dhaliwal reflects on the evolving expectations of young doctors, highlighting how advancements in medical education can enhance clinical reasoning skills.

The podcast dives into the critical role of differential diagnosis in clinical reasoning, emphasizing a balance between intuitive and analytical thinking. It addresses the complexities faced by medical education and the challenges of relying solely on intuition. The hosts outline systematic approaches to generating diagnoses for common symptoms, stressing the importance of personalizing methods for improved clinical recall. The episode also explores the necessity of precise medical terminology in crafting accurate problem representations, while highlighting the need to counteract biases.