Many internists are too overconfident, with the data suggesting a diagnostic error rate between 5 and 15 percent.
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Not a bad rate I think. I don’t want to see someone who has to be 100% right everytime–I’ll never get out without a 200,000 dollar bill.
The trick is to know when a low level of confidence is good enough, and when it isn’t. That is a function of the risk of the offered treatment for the probably diagnosis and the risk of missing the alternatives. How likely am I missing something bad? What is the likelyhood that I could do something about it if I did find this was really someting else? There is usually no need to go overboard being certain of self-limiting conditions or conditions not very treatable anyway. And there is nothing wrong with having a low threshold for diagnosing and treating the things that can be treated easily and cheaply with low risks.
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