Israeli Research: Old-Fashioned MD Exams Better than Hi-Tech
Direct-to-patient dialogue and physicians’ exams often are more useful to hospital doctors than hi-tech scans, according to an Israeli research team from the Kaplan Medical Center in Rehovot, south of Tel Aviv.
The research, published in the Archives of Internal Medicine, revealed that doctors said that CT scans and ultrasounds in the emergency room not only cost lots of money but also helped in diagnoses in only a small part of the cases studied.
The research team also said that radiation from CTs, which hospital doctors usually dismiss as minimal, might increase the risk of cancer.
"Basic clinical skills remain a powerful tool, sufficient for achieving an accurate diagnosis in most cases," wrote Kaplan research Ami Schattner and his research team. They spent two months following up on 442 patients who were treated in the emergency room and later were admitted to the hospital.
Each patient was examined by separately by two doctors, a resident and a senior physician, who talked with the patients about their medical history. They also had full access to results of emergency room scans.
After comparing the final diagnoses with the doctors’ initial decisions, the researchers discovered that the personal diagnoses were correct more than 80 percent of the time. It was not clear whether the level of the doctors' specialization, experience and standing were factored into the results and whether that did or did not make a difference.
"Physicians may count more on their clinical faculties when making decisions about patients,” the study concluded.
The doctors told the researchers that in cases where the patients also underwent CT scans, the results were helpful in making final diagnoses in only one-third of the cases, while the physical exam and understanding patients’ medical histories were most important in approximately 60 percent of the cases.
Reporting the results of the research, Reuters quoted a University of Toronto cardiologist as saying, "The doctoring process is still a personal communication between the patient and the clinician".
"As much as we want to... rely on the technology, it's not the technology that helps us make a diagnosis.”