Clinical Decision Quotes

As a pediatric neurosurgeon, I frequently faced life and death situations, and had to come up with the right diagnosis, the right plan, and execute that plan frequently with other colleagues.

The dilemma of modern medicine, and the underlying central flaw in medical education and, most of all, in the training of interns, is the irresistible drive to do something, anything. It is expected by patients and too often agreed to by their doctors, in the face of ignorance.

As a medical doctor, it is my duty to evaluate the situation with as much data as I can gather and as much expertise as I have and as much experience as I have to determine whether or not the wish of the patient is medically justified.

To become comfortable with uncertainty is one of the primary goals in the training of a physician.

My opinion has always been that when it comes to deciding where specialist centres should be located, whether they are regional or national specialities, it should be done on clinical grounds.

A good surgeon doesn't just concentrate on technical ability, but also on the appropriateness of what you're doing.

The theory of medicine, therefore, presents what is useful in thought, but does not indicate how it is to be applied in practice-the mode of operation of these principles. The theory, when mastered, gives us a certain kind of knowledge. Thus we say, for example, there are three forms of fevers and nine constitutions. The practice of medicine is not the work which the physician carries out, but is that branch of medical knowledge which, when acquired, enables one to form an opinion upon which to base the proper plan of treatment.

At the WTO, it's never a general surgery. It's always a very specific, clinical, precise surgery - and you can't miss the target. If you miss the target, you kill the patient. It's as simple as that.

In diagnosis think of the easy first.

We must never neglect the patient's own use of his symptoms.

Good doctors exercise judgment. They make the call and - right or wrong - live with the consequences and learn from them. The redefined M.D. is flawed, but comfortable inside their own skin.

When a physician is called to a patient, he should decide on the diagnosis, then the prognosis, and then the treatment. ... Physicians must know the evolution of the disease, its duration and gravity in order to predict its course and outcome. Here statistics intervene to guide physicians, by teaching them the proportion of mortal cases, and if observation has also shown that the successful and unsuccessful cases can be recognized by certain signs, then the prognosis is more certain.

There are some modern practitioners, who declaim against medical theory in general, not considering that to think is to theorize; and that no one can direct a method of cure to a person labouring under disease, without thinking, that is, without theorizing; and happy therefore is the patient, whose physician possesses the best theory.