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The Lost Art of the Diagnotician
By Ralph Alterowitz
There used to be a class of doctors that we called diagnosticians. They were the physicians who could put disparate pieces of medical information into a meaningful pattern and diagnose the problem. Or people would come to them with an ailment that the family doctor could not solve.
Since World War II, old medical specialties have been fragmented into many subspecialties. And there are many new specialties. Research has increased exponentially, resulting in indigestible volumes for most practitioners. With long days spent taking care of patients with a broad spectrum of diseases in every medical segment, practitioners have little time to stay current on every disease in their area of competence.
So today, most people do not have doctors who look at problems affecting their patients outside their medical specialty, and who understand the relationships of the symptoms presented. It is a real gift to find a physician who has the capacity to “put the whole picture together.”
Several years ago, I went to Dr. Charles Myers for a prostate checkup. Many prostate patients know him as the force behind the Prostate Forum, which counsels patients on using diet to manage prostate disease. As with most new patients, I had to complete a questionnaire about my medical history. Afterward, Dr. Myers performed a comprehensive physical examination complemented by a battery of blood tests. The same thing happened the following year. Recently, I saw him again. As many people know, he took a leave of absence to manage his own bout with prostate cancer.
In each visit, Dr. Myers identified a current or potential problem outside the prostate cancer realm, helping me to address the problem before it became serious. As he conducted his examination, he dictated his findings to his assistant. After reviewing the report and his observations, I realized that he was today’s version of the old diagnostician, one who can identify the problems and understand their relationships.
To find a prostate cancer physician who practices the specialty and is the embodiment of the diagnostician is extremely rare. I know of doctors competent in their specialty who tell their patients, ”I’m not interested in that,” when asked about a problem or symptom outside their expertise. Dr. Myers is a great example of a doctor who looks at the patient in a holistic fashion.
Part of our mission at ECPCP is to give patients the tools to obtain quality medical care. When you evaluate whether you want to work with a doctor on an ongoing basis, one of the criteria you may want to use is his or her ability to integrate different symptoms, both within and outside the area of specialty.
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