ABSTRACT
The good doctor and diagnostic skills The public has long identified diagnostic skills as a mark of the 'good' physician. Examples of diagnostic prowess and triumphs are readily found in popular culture. Dr Leonard Gillespie, the wise and crusty physician in the popular Dr Kildare movies from 1937 to 1947 (see also Chapter 2), was the consummate diagnostician. And, in the 1945 novel Medical Practice, the death of a fiancee due to a 'wrong diagnosis' led physician Peter McDonald to become a 'diagnostician' instead of following in his father's footsteps into general practice.1 In fact, the public esteem given to diagnosis - partly due to reverence for the latest medical science and technology - was one factor behind the rising status, from the 1920s onward, of specialists over general medical practitioners. In 1930, one American physician opined that the 'latest substitute for the breadth of vision of the general practitioner is that offspring of the American God of Efficiency, the Diagnostic Clinic'. He added that such clinics, owned by groups of specialists, were sometimes run as machines where 'the patient is automatically passed from one specialist to another ... submitted to a series of examinations, so detailed in their nature that it would seem that nothing could be overlooked', and with no one practitioner there to 'understand the situation as a whole'.2
