How do they do it?

Really cool article with commentary attempting to investigate how experienced docs walk into a room and smell the diagnosis and dispo in a few seconds. Looks like most of the “reasoning” is done before even seeing the patient. Read the RN notes!

As a resident I made a comment about Dr Mallory’s knowing the unteachable. I think this diagnostic skill is learnable but maybe not teachable. It can be called intuition. Pattern recognition. Etc.

Post-Publication Peer Review

For those who have not been introduced to this concept, here is a blog post from Dr Radecki who writes the EM Lit of Note.

Because blog posts are not “peer-reviewed” before they are posted, the quality of a given post could be low. But depending on how many people read the post, the discussion can be lively and constructive.

This is in contrast to formal journal publication, where the peer review is PRE-publication, and discussion may be minimal. We will see a comment or two in an issue a month or two later, sometimes an official comment in the same issue. But the volume and even quality of responses possible with blogs, twitter, etc may surpass that of the official, slow process in the journals.

Scientific American had a nice article about this PPPR concept. As FOAMed and social media continues to expand in medicine, and in other fields, I think we will see more respect for this type of peer-review.