Diagnosis: Process not Product

Abstract

In this paper we hope to show that diagnosis can most usefully be seen as a process of thinking rather than a product of clinical enquiry. In doing so, it will be necessary to put our work in context by considering the variety of ways in which diagnosis, as process or product, has been conceptualised and presented by other workers and the assumptions, limitations and implications which are inherent in those ways. Our own research into the process of diagnosis has concentrated on final year medical students, house officers and registrars in general (hospital) medicine. Thus it is necessary for us to establish the generalisability of our findings to the general practice context. The presentation of our results will include a brief description of our research methodology to establish the validity of our data since unsubstantiated, speculative assertions are often made about the nature of the clinician’s thinking process. The description of our findings includes particularly a discussion of change and development within the individual clinician which bears upon the hospital training — general practice transition as well as the learning effects of clinical practice itself.