Getting things right 58 percent of the time is about as much good as asking a medical student.

Although this might not be a completely apt comparison. When NEJM ran its weekly Case records of the Mass Gen hospital there were always diagnoses sought from the visiting expert, local attendings and local med students. The students there had an impressive track record, better than the visiting expert physician. It was however speculated that as the cases were generated from the local hospital, the students had the advantage of local institutional memory.

If one has no clue where to begin, then casting a net broadly to include as many ideas as possible is a good idea. Then one must wheedle the list down without spending as much money as possible. The rational practice of medicine is the parsimonious selection of the fewest and least invasive tests that will confirm the diagnosis sufficiently to lead to appropriate intervention.

Any fool can order every test possible and then let the consultants figure out what it all means. As a patient you have to choose whether you want every possible exam done to you or just enough to get the job done in all probability.