It happen very frequently that many patients come to me for 2nd opinion. These patients has already shown to another two-three different doctors & all of them put different diagnosis & suggested different treatment. It creates very confusion in patient’s mind about who is right & who is wrong? & what to do next?.
Now, if we consider treating patient is 100% science than rule of science is same everywhere in the world & There should be no difference between diagnosis & treatment of different doctors.
The intern doctor might recognise vague categorical level of abdominal pain , master physician with her sensitivity to small differences that only experience can teach -recognise precise category of “appendicitis induced pain”. In other word, by experience doctors defined pattern of disease or develop “intuition or gut feeling” for diagnosing patient. This intuition is total art, one can not described it in the words. It’s my habit that after completing any operation, i evaluate my steps during operation. Many times i don’t have any answer, why i have taken this steps in operation, which was beneficiary to patient. It’s total intuition , it develops by vicarious learning experience & it works very well in treating patient.
so my take is treating patient is both “art” and “science”. Art must precede science. What to reject from differential diagnosis that comes from art, than comes science part for treatment of patient. If one use science part first than it’s horrible mistake, not many option are eliminated which leads to confusion & wrong treatment. The “art and science” get almost equal weightage in treatment. “Art” i would say 50.1% & “science” is 49.9%. But that minor difference can hugely impact outcome..