In a New York Times magazine story by Lisa Sanders, this observation about medical diagnostics reminded me of the early prognostications for computer-aided medical diagnosis. What is the current state of the art? Is the diametrically opposite strengths of the novice and the seasoned diagnostician as depicted in Sanders' story?
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It’s a truism in medicine that difficult diagnoses are most likely to be made by the most or least experienced doctors. The most senior have a wide set of experiences to draw on. Whatever the diagnosis, there is a good chance that they have seen it. The novice doesn’t count on experience for guidance. His head is still stuffed with all the possibilities he read about in school — the rare diseases just as common in his experience as the more usual ones. The fact that the doctors caring for this patient had no experience with this disease but were well aware of the potentially fatal consequences of treatment made a difficult diagnosis even more so. In this setting, making a diagnosis is not simply an act of reason; it is a leap of faith.
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