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|American Hospital of Paris, France|
|Keynote: J Clin Exp Cardiolog|
|Professor Fred Siguier (1909-1972) a major physician in the 50’ use to start a patient’s exam saying “Tell me exactly, precisely, in which circumstances your health problem started” Professor Siguier suffered of progressive blindness. So he asked to his assistants to make a full examination and to report their findings to their master’s sagacity. People with rare, but not only, diseases came from everywhere, seeking for Siguier’s perceptiveness to make clinical diagnosis he was a legend, the father of Internal Medicine. Of course it is an old story and so clinical exam. Thing are not the same actually, medical history and searching for a splenomegaly, describing cardiac murmur are obsolete. X-rays, Ultrasounds are doing this job. The question is where is the relationship between physician and his (her) patient? The answer is in the computer sir! No need for making a full history, it is in the patient’s file, no need to point out a specific symptom, it is in the Medical report. Time is money: ask for all the laboratory tests and most imaging at the same time “in a parallel way” we will discuss after of the results…and the discovery of “abnormalities” we were not searching! However, what needs the patient from his doctor is: physician’s attention. The patient likes the palpation of his (her) abdomen, the listening of his (her) lungs, feeling doctor‘s hands on his (her) body searching for an abnormality “it hurts here doctor!” Considering efficiency/cost ratio clinical exam is without any doubt the leader, leaving far away RMI, specific and expensive lab tests. “Ecoutez le malade, il vous donne, vous offre généreusement le diagnostic.” (Listen to the patient, he gives you, he generously offers to you the diagnosis” Used to say Fred Siguier.|
Jean Pierre Usdin MD., is a Former Internal of the Hospitals of Paris, Former Head of clinic, Assistant of the Hospitals of Paris, Former consultant in scientific committee of medical Journal CONSENSUS and previous Chief of the cardiologic department of American Hospital of Paris (2006-2012). He is currently renowned Cardiologist at American Hospital of Paris, Member of European Society of Cardiology, Member of French Society of Cardiology. Being a Journalist and Blogger in Medscape France (From 2010) he has blogs dedicated to general cardiology: reports discussions and notes about trials, cardiology congresses, live-comments on 2015 ESC congress in London.
Email: [email protected]
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