Diagnostic Skill, Mechanisation and Practitioner Development

[Guest guest]

This discussion about developing diagnostic skill versus opting to use technical

diagnostic

equipment is very important (and I say 'versus' here because I DO believe for

most of us,

this is a choice between two very different paths.

I have a few comments I would like to put out there.

First and foremost, I need to reiterate that I am not advocating some

'anthropological

position' that everything old is to be 'preserved and protected' in our

medicine. To the

contrary, I believe wholeheartedly that does need an upgrade to

this

millenium on many fronts.

But I do believe that offers a profoundly rich and deep

opportunity for

practitioners to cultivate diagnostic skill and that personal cultivation (which

in turn raises

practitioner cultivation) is all tied in with that process. Just for example,

get your hands

on the 800 page book Leon Hammer has published on his pulse diagnosis system

after a

lifetime dedicated to its mastery - its breathaking.

The journey a junior practitioner goes on when pursuing such development is

important. I

practice Kiiko Matsumoto's palpatory system - when I first learned the system -

it was

overwhelming - and it typically took me 20-25 minutes to palpate a patient from

head to

toe and integrate all the information. Now, after 10 years of doing that, I can

palpate a

patient from head to toe in 3-5 minutes, integrate the information in 1 minute

and

proceed to treatment. That process of proceeding through various stages of

confusion and

complexity into full integration is critical to maturity and development. The

same is likely

to be true if one pursues mastery of pulse or tongue diagnosis.

Consider mastering a musical instrument as an analogy.

Its possible to just purchase a player piano complete with paper rolls for all

ones favourite

tunes, plug the thing in and let it play. Or its possible to spend 10-20 years

mastering

the piano so one can play all the tunes themselves. The difference between the

two

scenarios should be obvious. What do you think Vladimir Horowitz would answer

if you

were to ask him whether he felt there was an advantage to having a player piano

play a

Mozart Piano concerto versus having him play it?

Daniel