[froglegz]

during a chat with two physicians recently i was amazed to find them confiding that they felt today's purveyors of medicine are sorely lacking in diagnostic capabilities. their point was this.... pre-hospital, in-hospital wherever it is we have far too many machines that we rely on for medical care and the art of medicine has practically vanished in some areas. this discussion came about because we had just finished an acls class and as i do during the rhythm recognition class i tell the story of winkebach who identified and accurately described the 2nd degree heart block which bears his name. he did this in 1899 but eindhoven did not invent the ecg until 1903. his description was made on visual and auditory observation alone. it is amazing to me that one's diagnostic skills could be so sharp as to do this. today we require a diagnostic quality monitor and a paper print-out before we would even think to commit to a dx of this condition.

so here is my challenge for the group...... turn off your pulse ox, take the batteries out of your monitor, and don't even think of the x-ray or ct. let's dx pts with pneumonia, intracerebral bleed, cardiac arrhythmias, and anything else you can come up with... pull out all your tricks of the trade and take medicine back 50 years....... maybe we will all learn something