Dhand et al. studied the diagnostic practices of community neurologists. [1] Experienced neurologists require little more than patient history supplemented by a general physical and neurological examination to diagnose disease. They may confirm their diagnosis with the aid of focused laboratory, neurophysiological, and radiological tests. In an ideal world, the paradigm for the majority of neurological should be C4 L1 N1. A shift from this paradigm to more testing (L4 N4) is due to many factors: the experience level of the neurologist; physician conflict of interest; fear of malpractice liability; and practice setting (academic center vs. small community hospital). It would be interesting to replicate this study in different clinical settings in various countries.
1. Dhand A, Engstrom J, Dhaliwal G. How experienced community
neurologists make diagnoses during clinical encounters. Neurology 2013; 81:1460-1466.
For disclosures, please contact the editorial office at journal@neurology.org.
Dhand et al. studied the diagnostic practices of community neurologists. [1] Experienced neurologists require little more than patient history supplemented by a general physical and neurological examination to diagnose disease. They may confirm their diagnosis with the aid of focused laboratory, neurophysiological, and radiological tests. In an ideal world, the paradigm for the majority of neurological should be C4 L1 N1. A shift from this paradigm to more testing (L4 N4) is due to many factors: the experience level of the neurologist; physician conflict of interest; fear of malpractice liability; and practice setting (academic center vs. small community hospital). It would be interesting to replicate this study in different clinical settings in various countries.
1. Dhand A, Engstrom J, Dhaliwal G. How experienced community neurologists make diagnoses during clinical encounters. Neurology 2013; 81:1460-1466.
For disclosures, please contact the editorial office at journal@neurology.org.