The Working Diagnosis
Chapter 11 Bedside Questions · 6 questions · about 6 minutes
Diagnostic deficiency, an absent or under-constituted Diagnostician, manifesting as fragmented governance across clinical, technical, operational, financial and regulatory domains. Competent specialists decide one domain at a time and no one is assigned the synthesis.
Committing to a diagnosis in the ED: chest pain, MI vs. aortic dissection, written with alternatives ruled out and confidence stated; diagnostic hesitancy as its own pathology.
Answer as your executive team would, with the evidence in hand. Each question has a factual answer in a system you already own.
Do you recognize your organization in the six candidate diagnoses; which would your executives have named before, and which now?
Add a note: where is the evidence, or who owns it?
Do you have a working cross-disciplinary, cross-executive synthesis function, or five excellent specialists and no lead physician?
Add a note: where is the evidence, or who owns it?
Have you ever committed a diagnosis like this to paper, with alternatives ruled out and reasoning documented?
Add a note: where is the evidence, or who owns it?
Run the threshold question on your own numbers: what would the informatics Function need to recover, as a fraction of your financial exposure, to pay for itself?
Add a note: where is the evidence, or who owns it?
Which of the three positions do you occupy: treat and measure, formally rule it out, or maintain a subtherapeutic dose?
Add a note: where is the evidence, or who owns it?
Are you early to this, or waiting for technology investment to resolve it?
Add a note: where is the evidence, or who owns it?
A reflection tool from the book, not a validated diagnostic test or benchmark. Your answers and notes stay in this browser unless you choose to send them. Please don't enter patient information.
The first step is not a purchase. It is an examination of the patient.
The Diagnostician, Chapter 11