Doctor’s knowledge making a diagnosis. Medical standards in shaping them

Viktoras Justickis, Tomas Saladis

Abstract


The paper focuses on the structure and content of doctor‘s knowledge that he uses making a diagnosis. It is analysed the ever increasing demands to doctor’s knowledge , arising from ever growing bulk of medical knowledge and increasing public expectations to the quality of medical service.
The sources of incongruence between increasing demands to the doctor’s knowledge and its ability to meet them are discussed. Lithuanian law sets up maximal demands to the doctor – he must possess every existing medical knowledge that can be useful treating his patient and in the case of proven lack of some such knowledge is responsible for any damage made by unsuccessful treatment. This demand overpasses the real capacity of human memory and stimulates spontaneous adaptation processes.
The paper proposed a special methodology for examination of the content and the structure of a doctor’s knowledge. This methodology is used for empirical study of doctor’s diagnostic knowledge.
The study discovered ways in which the doctor adapts to the modern, his capacity overpassing demands. Two principle ways of his adaptation have been demonstrated.
1. Great part of possible diseases is excluded from memory and from diagnosis;
2. The approach to information on another part of possible diseases is impeded. They are available only when some additional prerequisites are present.
Both adaptations really simplify the diagnosis and dumps the memory. However it is done at the expense of the dropping the quality of diagnosis.
The ways for solution of this problem are discussed.

Keywords


medical information; communication barriers; medical professional standards; clinical diagnosis; doctor‘s liability; doctor‘s knowledge gydytojų klaidos; teisiniai reikalavimai gydytojui

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"Health Policy and Management" ISSN online 2029-9001 / ISSN print 2029-3569