Laboratory tests should never be a substitute for taking a patient’s detailed history and structured physical examination, Y.K.Amdekar, Mumbai-based paediatric expert, said on Sunday.
Delivering the tenth Millennium Oration hosted by the Kanchi Kamakoti CHILDS Trust Hospital, Dr.Amdekar said that while machines had their own value, they (equipment) cannot replace human intelligence.
Advocating the “undergraduate approach” in which history taking and clinical examination provided the armamentarium for diagnosis, Dr. Amdekar said listening to a patient often served up vital clues and specific leads that investigations failed to provide. He urged young doctors to go through the basics while examining a patient, as clinicians risked missing the diagnosis if they forgot the fundamentals in their overwhelming exposure to information and knowledge.
Pointing out that patient history began with name and age, Dr. Amdekar told the audience of post-graduate students that while exceptions were always there in clinical medicine it was best to go by the established rules. “Many times, important clues are offered during routine evaluation but we fail to pick them up,” he said, citing a number of case studies.
According to the paediatric expert, evaluating the personal history was as important as studying the nature of onset, progression and duration of a fever or diarrhoea. Often, it was while listening to a patient’s personal history that clinicians got to know about behavioural symptoms such as irritability, he said.
The former Election Commissioner, T.S.Krishnamurthy, said governments had to accord high priority to health and education to facilitate growth and development of the national economy.
He pointed out that public health, especially child and neonatal health, was not being given the serious attention it warranted.
N. Kannan, chief paediatrician, Southern Railway Headquarters Hospital, released a souvenir on the occasion.
K. Mathangi Ramakrishnan, chairperson, Childs Trust Medical Research Foundation, and A. Andal, medical director, also spoke.
