March 6th 2014 is Change Day in Australia. Change Day is a movement promoted by individuals working within the health system. It is all about each of us Making a Pledge to do one thing (or many things) to improve the health and wellbeing of others. What pledge can you make to improve patient, client and consumer health outcomes?
I think this is an important project – it is not about hospitals, health services or government – it is all about the little things that individuals can do to make a small difference to their own ‘sphere of influence’ and do better for those with whom they come into contact.
Here is mine: “I’m pledging to promote and teach a rational approach to diagnostic testing in order to prevent over diagnosis, unnecessary and costly interventions and patient harm.”
So here is how I am hoping to do so. Plagiarism.
I am a huge fan of Dr David Newman (Smart EM) of the Mt Sinai School of Medicine New York City. I was lucky enough to cross paths with David on the FOAM circuit last year and he is truly an inspirational speaker and a gentleman of profound knowledge. So I am happy to stand upon his shoulders in order to honour my pledge.
Dr Newman has developed his own “4 Axioms of Diagnostic testing” – if you want to hear it from him check out the Smart Testing podcast. Time well spent.
However, if you want to be slack and want it in a quick & easy format here is my “adaptation”, perversion and expansion of the Laws. Also a hat tip to my friend Dr Anand Senthi for some of the concepts. You should be aware that by “test” I am using a very broad definition – it includes most of the questions and clinical examinations that you perform – not just the bloods and imaging that you use every day.
Click to get examples of each Law.
OK, those are my 7 Laws of Diagnsotics. Would love to hear your additions, subtractions or examples. As always – I am frequently wrong, so please let me know why on the comments below.