Clinical paradigms revisited

Andrew P Wright
Med J Aust 2007; 186 (7): . || doi: 10.5694/j.1326-5377.2007.tb00949.x
Published online: 2 April 2007

To the Editor: I was surprised by Wong’s letter on the role of history-taking and examination in the diagnostic process.1 I would suggest that Wong, as a surgical registrar, receives the majority of his abdominal pain referrals from the medical staff of the emergency department. Although he advocates the liberal use of abdominal computed tomography (CT) scanning, I believe he ignores the fact that another medical practitioner has already taken a history and performed an examination that has suggested a surgical cause of pain for which a surgical opinion is then requested. Wong would thus remain unaware of other cases in which patients present with abdominal pain but the case is ruled non-surgical on the basis of history, examination and limited investigation not involving abdominal CT scanning.

  • Department of Anaesthesia, Concord Repatriation General Hospital, Sydney, NSW.


  • 1. Wong K. Clinical paradigms revisited [letter]. Med J Aust 2006; 185: 671-672. <MJA full text>
  • 2. Schattner A. Clinical paradigms revisited [letter]. Med J Aust 2006; 185: 672. <MJA full text>


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