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|Suprise, surprise, as medical schools scramble to introduce curriculum reform to keep pace with mediocrity, they eliminate the microscope, the doctor's personal lab, the autopsy, and in the name of confidentiality and privacy, bedside teaching is all but forgotten. Sub standard medical schools are a growth industry. Best evidence concentrates so on treatments that we have treatments in search of a diagnosis, particularly expensive highly profitable procedures or drugs. We teach with "standardized patients" a synanym for actors who can never teach the student the reality of a disease or its diagnosis. In our haste to produce alternative providers, we treat health care at the lowest denominator of competence. Any one with a stethescope around their neck is a provider. There are still true physicians, but they are fenw and far between. We still have great medical schools but they are under pressure to make the big bucks, to be self sustaining. Physicians today struggle with commercializations as renasance physicians struggled with the church.
(EMR) Electronic Medical Record, (DSS) Discussion Support Systems, Translational Medicine, Current Medical Information Terminology, the architecture of design largely ignores differential diagnosis and current medical information. A Tsunami of new biomedical knowledge changes half of what we know and overwhelms attempts at setting standards. We lack a dynamic current medical information database that is accessible to the clinician and that can quantitate diagnostic evidence based on outcome.
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