You searched for diagnostic reasoning - CLOSLER

November 29, 2018 | 2 min read

Management Reasoning: Diagnostic Reasoning’s Underappreciated Sibling

By David Cook, MD, MHPE

Management reasoning is primarily a task of shared decision-making and monitoring, and is inherently more complex than diagnostic reasoning. A better understanding of management reasoning will offer insights into the causes and avoidance of medical error, clinical practice quality improvement, and training and assessment of health professionals.

Anchoring bias occurs when we rely too heavily on information received up front and too little on information received later when making a judgement about the most likely diagnosis.

November 26, 2024 | 4 min read

Lessening the chances of making diagnostic errors

By Elizabeth Fracica, MD, MPH, Johns Hopkins Medicine

To minimize common mistakes in diagnoses, clinicians must be mindful of cognitive and anchoring biases. Regularly seeking alternative explanations is one way to accomplish this.

February 25, 2018 | 1 min read

Diagnostic Excellence Starts With an Incessant Watch

By Reza Manesh, MD, Johns Hopkins University School of Medicine

Feedback is the key to improvement of any craft. No one is born an expert. It is earned through deliberate practice and an incessant thirst for progress.

July 23, 2020 | 3 min read

Stepping Back Before Moving Forward

By Moises Auron, MD, Cleveland Clinic

Considering multiple diagnostic possibilities and not anchoring on the incoming diagnosis may increase the chance of getting it right.

February 23, 2018 | 2 min read

Mindfulness and Diagnostic Acumen: Inversely Related?

By Sharon Solomon, MD, Johns Hopkins Medicine

Far from being inversely related, physician mindfulness provides the foundation upon which diagnostic acumen is built.

August 7, 2024 | 1 min read

The rat

Soliciting diverse perspectives and considering unexpected etiologies can improve diagnostic accuracy. Answers to clinical puzzles may be rooted in cultural and geographic specificities.

November 18, 2024 | 3 min read

Starting from scratch

By Erica Richards, MD, Johns Hopkins Medicine

Eliciting detailed stories about patients’ experiences is invaluable in healthcare. Approaching history-taking in a thorough manner allowed me to discover that a brain tumor was causing a patient’s psychiatric symptoms.

August 7, 2024 | 2 min read

Wait! Is that a zebra?

Common things are common, but occasionally unusual conditions are seen. To improve diagnostic accuracy, clinicians should consider alternative explanations and challenge their own assumptions.

July 22, 2024 | 1 min read

The third guest—ambiguity

By Javier Rascon, MD, Mallorca, Spain

Before a specific diagnosis has been established, clear communication is paramount. Use of metaphors, reviewing what is known so far, and encouraging questions builds trust and reduces patient fear.

December 5, 2023 | 3 min read

Museums make me a better clinician

By Johannes Thorman, MD, Scania University Hospital, Malmo, Sweden

Museum-based health professions education is an emerging field. Studying visual art can help healthcare professionals become more patient, collaborative, rigorous, and appreciative of their colleagues.

Three common zebras (Equus quagga), Kruger National Park, South Africa.

August 18, 2020 | 2 min read

Zebras Are Out There

By Eric Last, DO, Northwell Health, Wantagh, New York

Looking at the big picture and verifying details will help you consider diagnoses that may be unlikely, but still possible.

February 5, 2025 | 1 min read

Pathological hiccups

Sometimes benign symptoms can herald more serious problems. Being ready and willing to reconsider initial impressions is crucial for accurately discovering the underlying etiology.

January 15, 2025 | 2 min read

A spray away from the answer

This clinical conundrum, related to hypoxia, underscores the importance of meticulous history-taking and the potential for unexpected complications with seemingly benign medications.

February 24, 2018 | 1 min read

Battling The System in Defense of Diagnosis

By Souvik Chatterjee, MD, Johns Hopkins Medicine

Healthcare delivery is at odds with a fundamental aspect of being a physician—strategic curriculum interventions are necessary to preserve the art of diagnosis.

October 14, 2019 | 4 min read

The Struggle Between Occam’s Razor and Hickam’s Dictum

By Kittane "Vishnu" Vishnupriya, MBBS, Johns Hopkins Medicine

Occam's razor and Hickam's dictum are both helpful tools when engaging in diagnostic reasoning.

October 9, 2019 | 3 min read

Return to Play

By John Wilckens, MD, Johns Hopkins Medicine

While research findings are critical for clinical decisions, they only support the human art of empathizing with and understanding your patients.

April 25, 2019 | 3 min read

Diagnostic Humility

By Nathan Douthit, MD, Brookwood Baptist Health, Birmingham, Alabama

Self-awareness is critical in making accurate diagnoses.

February 24, 2025 | 2 min read

Listening to find answers

By Michael Albert, MD, Johns Hopkins Medicine

To more accurately arrive at the diagnosis, it is generally wise to believe patients’ recounting of their symptoms and experiences. This can result in uncovering medical conditions that are sometimes labeled as being more generalized—like anxiety—and lead to improved patient outcomes.

June 25, 2018 | 2 min read

Trust The Diagnostic Process

By Michael Crocetti, MD, MPH, Johns Hopkins Community Physicians

Clinicians use a diagnostic process to guide their actions when faced with a medical problem. Hypothesis generation provides an efficient reliable framework to focus the clinical workup and come to the correct diagnosis and treatment plan.

August 16, 2021 | 3 min read

The Heart of Clinical Reasoning

By Susrutha “Sus” Kotwal, MBBS, MD, Johns Hopkins Medicine

Making a diagnostic error reminded me that connecting with patients on a personal level is necessary for optimal clinical reasoning.

November 22, 2021 | 4 min read

Noticing What We’ve Seen Without Seeing

By Ekene Ojukwu, MD, Johns Hopkins Medicine

Carefully observing our patients can lead to clinically relevant insights. Sometimes what seems inconsequential at first glance may be surprisingly significant.

August 1, 2019 | 3 min read

Mindset and the Power of Yet: A Conversation With Dr. Gurpreet Dhaliwal

By Sam Kant, MD, Johns Hopkins University School of Medicine

Excellent clinicians are also thoughtful mentors. Mentors are like beacons as we navigate our path forward.

September 13, 2021 | 4 min read

Only Connect

By Susrutha “Sus” Kotwal, MBBS, MD, Johns Hopkins Medicine

Missing a diagnosis made me realize the value of a thorough physical exam. It can often illuminate the cause of the illness.

December 17, 2019 | 4 min read

Stop, Look, and Listen

By Chase Webber, DO, Vanderbilt University Medical Center

From a young age, children learn to “Stop, Look, and Listen” when crossing the street. Clinicians would do well to live by these words in the realm of clinical reasoning.

June 3, 2019 | 1 min read

Every Piece of Data Matters

By Rabih Geha, MD, University of California San Francisco

Bolded, flagged, or typed in a different color, an abnormal result demands the mind’s eye in many modern EMRs, but it is equally important to direct our gaze to the quietly normal labs; not uncommonly, they may be screaming a powerful clue.

July 1, 2019 | 1 min read

Looking Under the Hood

By Daniel Minter, MD, University of California, San Francisco

Promoting a culture of thinking out loud can demystify the process of clinical reasoning and make it accessible to all learners.

August 7, 2024 | 3 min read

“Far from the madding crowd”

By Kittane "Vishnu" Vishnupriya, MBBS, Johns Hopkins Medicine

Every extra hour that a patient spends in the ER worsens mortality. Clinicians can make changes to address this problem, like reorganizing rounding to see potential discharge-ready patients first.

October 24, 2023 | 6 min read

Hoping

By Eric Last, DO, Northwell Health, Wantagh, New York

Even when a cure is not possible, I try to show patients and their loved ones that there are other things for which to hope.

April 10, 2018 | 3 min read

Finding Beauty In Your Inbox

By Scott Wright, MD, Johns Hopkins Medicine

Sometimes, beauty and inspiration are inches away from our eyes, glowing at us from the blue light of our screen. Dr. Wright shares a moving story from a recent email exchange between a resident and attending.

December 16, 2019 | 4 min read

Top 10 Tips to be a Great Consultant

By Aline Charabaty, MD, Johns Hopkins Medicine

Read these 10 tips so that next time your pager goes off, you can be an outstanding consultant!

September 1, 2021 | 2 min read

What’s The Problem?

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

Systematically formulating a clear statement of the patient’s problem can be incredibly helpful. This may improve your diagnostic reasoning and ability to formulate more effective therapeutic plans.

November 5, 2019 | 3 min read

A Series of Biases: Murphy’s Law at Play

By Sonal Gandhi, MBBS, MD, Johns Hopkins Medicine

Biases get in the way of our clinical reasoning. When the data doesn't fit, clinically excellent providers re-examine their assumptions.

March 20, 2019 | 4 min read

Social History as Story

By Colleen Farrell, MD, New York University

We cannot understand our patients’ bodies if we do not understand something about who they are as human beings,

September 17, 2018 | 2 min read

Listening, Educating, and Giving Reassurance

By Sharon Solomon, MD, Johns Hopkins Medicine

By focusing on one patient at a time, 35-40 per day, my mission and approach to patient care is to listen, to educate, to intervene with treatment when I can, and to provide reassurance.

April 3, 2025 | 3 min read

The unknown variable

By Eve Glenn, ScB, medical student, Johns Hopkins Medicine

Providing excellent patient care requires being in the liminal space between scientific certainty and human ambiguity. This is a place from which to bear witness to suffering with both intellectual curiosity and deep empathy.

April 17, 2024 | 2 min read

Kratom—the opioid-like herbal drug your patients may be using

By Megan Buresh, MD, Johns Hopkins Medicine

Kratom use is on the rise. It is important to ask patients about use in a nonjudgmental manner.

November 27, 2023 | 2 min read

When the truth (literally) hurts

By Eric Last, DO, Northwell Health, Wantagh, New York

When our patients are facing surgery or other procedures, thoughtful questions can help allay their worries.

August 3, 2023 | 3 min read

A Glass of Milk

By Kyle Glienke, MD, Buena Vista Regional Medical Center, Iowa

When I was working with my grandpa as a dairy farmer, he said what made it all worth it was knowing how many children needed the milk. As a doctor, I find meaning by reminding myself how many people need care.

April 14, 2022 | 3 min read

Afraid to Tell The Truth

By Kirsten Elin Smith, PhD, National Institute on Drug Abuse

When I shared with my clinician that I had previously been a heroin user, she made me feel ashamed. This taught me the importance of listening to patients with nonjudgmental curiosity.

The Baltimore Museum of Art. Wikipedia.org. Photograph by Eli Pousson, 2018 March 25.

April 7, 2020 | 3 min read

The Personal Responses Tour in Medical Education

By Howard Chang, Medical Student, Johns Hopkins Medicine

Arts-based medical education improves fundamental clinical skills, including ambiguity tolerance, reflective ability, bias awareness, and empathy. It can also enhance the well-being of healthcare professionals.

March 12, 2020 | 4 min read

What I learned from my primary care mentors

By Colleen Farrell, MD, New York University

All of us can learn from primary care clinicians, who know that listening, compassion, and connection are the foundations of clinical excellence.

November 3, 2021 | 2 min read

Diagnosing And Treating Pain

By Rebekah Fenton, MD, Northwestern University

Always listen to your patients and make sure that they understand that you believe their experience of pain.

April 5, 2021 | 2 min read

Slowing Down at The Bedside

By Sanjana Mathur, MBBS, University of Central Florida

Physically examining your patient takes time and cannot be rushed. Having a methodical approach will help you make accurate assessments when examining patients.

February 26, 2019 | 4 min read

On “Great” Diagnoses

By Nathan Douthit, MD, Brookwood Baptist Health, Birmingham, Alabama

Making an accurate diagnosis and giving a name to our patient's illness is a crucial component of acceptance and healing for the patient and their family.

March 19, 2019 | 3 min read

Reversing the Backslide: Sexually Transmitted Infections in the US

By Matthew Hamill, MBChB, PhD, Johns Hopkins Medicine

Open, non-judgmental, respectful, medically-relevant conversations need to be the cornerstone of all therapeutic relationships. As long as patients feel valued and at the center of their care, patients are willing to engage in discussions about sexually transmitted infections.