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What is the #1 priority of a physician’s education? It is to become a good diagnostician. To answer the question “what is the diagnosis?” I challenge physicians to ask whether this is the most important question.

We are trained to take the presenting signs and symptoms then put it inside a box with a label. Then we treat all those patients with that label using “evidence based medicine” – algorithm X for everyone with diagnosis X. I used to love algorithms – not so much anymore. Labeling patients with diagnoses is contributing to escalating health care costs as well as the incidence of age-related disease. We are spending more on health care and ironically getting sicker at the same time (more on this later).

The #1 question we should be asking is not “what is the diagnosis?” but “why does the patient have the symptoms?” What body system or process is out of balance. Symptoms are nature’s way of saying that something is no longer working the way it should and it is usually because the owner of the body is not taking proper care of it.

I believe that this change in our approach will have the biggest impact in the health of our patients. So next time you evaluate a patient, first ask “why?” not “what?”

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