In the flourishing development of modern medicine, various advanced diagnostic instruments, such as CT, MRI, ultrasound, and laboratory tests, have become indispensable pillars in the field of clinical diagnosis and treatment. With precise data and clear visual images, they provide strong support for disease diagnosis, acting like a guiding light for doctors in the fog. However, like the other side of a coin, the phenomenon of doctors over-relying on instrumental diagnosis has quietly emerged, prompting deep reflection on the essence of medicine and humanistic care.
1. Specific Manifestations of Overreliance on Instrumental Diagnosis
(1) Neglect of Basic Clinical Skills
Currently, some doctors, when facing patients, treat the crucial steps of inquiry and physical examination as mere formalities, even omitting basic examination steps such as inspection, palpation, and auscultation, as if these traditional diagnostic methods are outdated. For example, when encountering a patient with abdominal pain, they may not patiently and thoroughly inquire about the specific location, nature of the pain, and possible triggers, but instead hastily arrange for abdominal CT or ultrasound examinations. This practice can lead to delays in diagnosing certain functional diseases or acute abdominal conditions like appendicitis, as key signs such as McBurney’s point tenderness are not identified in a timely manner, causing unnecessary suffering for the patient.
(2) Blind Pursuit of ‘High-End Examinations’
In clinical practice, some doctors, in pursuit of so-called ‘comprehensiveness’ or simply to avoid medical risks, often excessively prescribe expensive tests. Take a common cold patient, for instance; they could be assessed through simple inquiry and basic examination, yet are advised to undergo a series of tests such as blood routine and chest CT. This not only unnecessarily increases the patient’s financial burden but may also pose potential health risks due to radiation exposure from CT scans.
(3) Interpretation of Data Detached from Clinical Reality
While the results provided by instrumental examinations are important, they must be interpreted in conjunction with the patient’s overall condition. However, in cases of overreliance on instruments, a phenomenon of ‘reportism’ has emerged. For example, upon discovering a small lung nodule during a health check, a doctor may directly classify it as ‘suspected tumor’ without adequately considering the patient’s smoking history, family history, and other important factors. This simplistic and crude diagnostic approach not only leads to overtreatment but also causes significant psychological panic for the patient, plunging them into unnecessary anxiety and worry.
2. Serious Harms of Overreliance on Instrumental Diagnosis
(1) Waste of Medical Resources
Unnecessary examinations significantly increase both medical insurance funds and personal medical expenses, akin to a bottomless pit continuously consuming limited medical resources, thereby exacerbating the burden on the entire healthcare system. This not only affects the rational allocation of medical resources but also places patients who genuinely need medical resources in a predicament of scarcity.
(2) Delays in Diagnosis Timing
In the diagnosis and treatment of some emergencies, time is of the essence. For instance, diseases like myocardial infarction and cerebral hemorrhage require doctors to make timely diagnoses and interventions through rapid physical examinations and basic tests (such as ECG). However, overreliance on instrumental examinations may lead to a cumbersome and lengthy diagnostic process, resulting in missed golden treatment opportunities, posing serious threats to patients’ health and lives.
(3) Alienation of Doctor-Patient Relationships
As instruments gradually replace face-to-face communication between doctors and patients, patients may feel a lack of care and empathy from their doctors. In their eyes, doctors seem to be mere ‘machines’ issuing test orders rather than compassionate and comforting healers. This lack of humanistic care in the diagnostic process can easily trigger a crisis of trust between patients and doctors, leading to tense and cold doctor-patient relationships.
(4) Degradation of Clinical Thinking
For young doctors, long-term overreliance on instrumental diagnosis is akin to being a flower in a greenhouse, lacking the training necessary for actual clinical diagnostic capabilities. They may gradually lose core clinical thinking skills such as history taking and logical reasoning, impacting the cultivation of medical talent and the long-term development of the medical profession.
3. Effective Paths to Achieve Balance Between Instruments and Clinical Practice
(1) Returning to the Essence of Medicine: Patient-Centered Care
We should re-emphasize the foundational role of ‘medical history + physical examination’ in clinical diagnosis, using instrumental examinations merely as auxiliary means. For example, when faced with a patient with fever, doctors should first conduct a detailed inquiry to understand the patient’s epidemiological history and accompanying symptoms, while also performing a comprehensive physical examination, such as checking for throat signs and examining lymph nodes for enlargement. Through these basic steps, the diagnostic scope can be narrowed, and then specific examinations can be selectively chosen based on the situation, rather than blindly relying on instruments for broad screening.
(2) Enhancing Doctors’ Comprehensive Abilities
Through standardized training, case discussions, and various methods, we can strengthen doctors’ clinical thinking training. Doctors should be encouraged to conduct dialectical analyses of instrumental examination data in conjunction with individual patient differences. For instance, in the case of blood sugar monitoring for diabetic patients, doctors should not only focus on the data on the lab report but also need to understand the patient’s dietary habits, exercise routines, and medication history to comprehensively assess the patient’s condition and develop more personalized and precise treatment plans.
(3) Standardizing Examination Indications and Processes
Establishing scientifically sound hierarchical diagnosis and examination indication guidelines can help avoid ‘net-casting’ blind examinations. Primary hospitals should fully leverage their foundational diagnostic capabilities, prioritizing basic examination projects. For difficult cases, timely referrals to higher-level hospitals for advanced instrumental examinations should be made. This can effectively improve the utilization efficiency of medical resources, ensuring that patients receive the most appropriate diagnosis and treatment.
(4) Integrating Humanistic Care
During the diagnostic process, doctors should actively communicate with patients, explaining the purpose and necessity of examinations in detail, and patiently interpreting the clinical significance of examination results. This approach can alleviate patients’ anxiety and rebuild their trust in doctors, allowing the doctor-patient relationship to return to a warm and harmonious state.
Conclusion
Diagnostic instruments are undoubtedly a great achievement of medical progress, bringing immense convenience and advancement to the field of medicine. However, we must recognize that the value of instruments lies in serving humanity and must never replace the wisdom and humanistic care of doctors. Only by closely integrating advanced technology with the clinical wisdom and humanistic care of doctors can we truly achieve the perfect unity of ‘precision medicine’ and ‘humanized care,’ allowing medicine to return to its original mission of ‘curing pain and caring for life.’