We bring you our second attempt at "stump the chumps".  Our friend and colleague Oliver Menzies brought an interesting case.  We think this case was not quite as enigmatic as our first one (episode 5) but we hope it illustrates sound clinical reasoning as we work our way through the clinical information.  Enjoy.

When we talk about medical errors, we need to remember that there are two victims; the patient who suffers harm as a result of the error, and the clinician who makes the error.  As long as the practice of medicine remains a human endeavour, medical errors are inevitable.  As a medical community we need to accept that errors will occur.  We need to talk about them openly and honestly, share our own stories, and support our colleagues when they share their stories with us. As members of society, we should better understand the fallibility of medical practitioners, and we need to understand the limits of their craft.

We had the opportunity to interview Brian Goldman, an ED doctor from Toronto, Canada, who is also a journalist, host of the CBC radio show "White Coat, Black Art", author of two books unveiling the secrets of medical culture, and a "TED-talker" with his presentation entitled "Doctors make mistakes - can we talk about that".

We also interviewed our friend and colleague, Dr. David Spriggs, a Brit who has lived in NZ for many years, an excellent general internist and geriatrician, who regularly teaches our trainees on the reality of making mistakes.

The future is coming.  In this episode we talk to Shantanu Nundy of the Human Diagnosis Project (HumanDx).  As Shantanu describes it, HumanDx is a worldwide effort to map any health problem to its possible diagnoses.  We have come across various projects that aim to create that elusive, high-fidelity, real-life, artificial intelligence of diagnosis.  HumanDx is building that AI by connecting the knowledge, experience, and real-life cases from all of us.  This is OUR project.  We think that HumanDx is the real thing.  Enjoy!

The Diagnostic Error in Medicine Conference 2015 has finally come!  We have been looking forward to attending this conference for a while now.  This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm.  These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard.

Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

The Diagnostic Error in Medicine Conference 2015 has finally come!  We have been looking forward to attending this conference for a while now.  This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm.  These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard.

Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

The Diagnostic Error in Medicine Conference 2015 has finally come!  We have been looking forward to attending this conference for a while now.  This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm.  These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard.

Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

As promised, we bring you our first attempt at "stump the chumps".  This is where we are presented with a challenging diagnostic case and we think out loud as we reason our way through it.  You can play along as you hear the case unfold.

Dr. Gurpreet Dhaliwal is professor of clinical medicine at UCSF and has written many articles in the realm of clinical reasoning.  Although you have already heard snippets of our conversation on prior episodes, we thought we would share the entire interview with all of you.  Gurpreet has an enlightening way of explaining how we think, and how we move from good clinicians to expert clinicians, through extended problem-solving and feedback.

The differential diagnosis is at the heart of analytic thinking for the diagnostician.  Dr. Mark Graber agrees.  As the founder of the Society to Improve Diagnosis in Medicine, he should know.  It can overcome many of the biases we are prone to when we limit ourselves only to diagnosis by pattern recognition.  We discuss some simple approaches to generating a differential diagnosis and developing a problem representation.

We continue laying the foundations of type 1 and type 2 thinking with a discussion about biases.  Once again we hear from Prof. Gurpreet Dhaliwal and some of his thoughts on the utility of studying metacognition.