Jean-Pierre Usdin
American Hospital of Paris, France
Title: Listening, speaking, understanding, clearing up the patient’s speech are the major keys in patient’s well-being
Biography
Biography: Jean-Pierre Usdin
Abstract
Professor Fred Siguier (1909-1972) a major physician in the 50’ use to start a patient’s exam saying “Tell me exactly, precisely, in which circumstances your health problem started” Professor Siguier suffered of progressive blindness. So he asked to his assistants to make a full examination and to report their findings to their master’s sagacity. People with rare, but not only, diseases came from everywhere, seeking for Siguier’s perceptiveness to make clinical diagnosis he was a legend, the father of Internal Medicine. Of course it is an old story and so clinical exam… Things are not the same actually, medical history and searching for a splenomegaly, describing cardiac murmur are obsolete. X-rays, Ultrasounds are doing this job. The question is where is the relationship between physician and his (her) patient? The answer is in the computer sir! No need for making a full history, it is in the patient’s file, no need to point out a specific symptom, it is in the Medical report. Time is money: ask for all the laboratory tests and most imaging at the same time “in a parallel way” we will discuss after of the results…and the discovery of “abnormalities” we were not searching! However, what needs the patient from his doctor is: physician’s attention. The patient likes the palpation of his (her) abdomen, the listening of his (her) lungs, feeling doctor‘s hands on his (her) body searching for an abnormality “it hurts here doctor!”
Considering efficiency/cost ratio clinical exam is without any doubt the leader, leaving far away RMI, specific and expensive lab tests.
“Ecoutez le malade, il vous donne, vous offre généreusement le diagnostic.” (Listen to the patient, he gives you, he generously offers to you the diagnosis” Used to say Fred Siguier .
