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Clinical paradigms revisited

Andrew P Wright
Med J Aust 2007; 186 (7): 381-383.
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.

  • Andrew P Wright

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

Correspondence: wrightan@tpg.com.au

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