0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Neurologists as Physician-Scientists

Nitin K. Sethi, MD1
[+] Author Affiliations
1Department of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, New York
JAMA Neurol. 2014;71(1):113. doi:10.1001/jamaneurol.2013.4813.
Text Size: A A A
Published online

Extract

To the Editor I read with interest Dr Berger’s Viewpoint1 on the neurologist as the last still-standing (proudly, I would say) physician scientist. He rightly pointed out that some of us still spend time getting a thorough history, formulating a differential diagnosis, and then relying on our examination skills to help localize the lesion to the correct level of the neural axis. The operational word though is some. Like our colleagues in other medical specialties, we too are getting slowly, but surely, corroded to take the easier path—do a cursory neurological examination and then order a panel of tests and imaging studies. So now we have a stroke workup, a dementia workup, multiple sclerosis workup, and who can ignore the all-encompassing neuropathy workup. After all, something shall reveal itself when the net cast is so wide. And we are slowly retiring the tools of our trade. Who needs a stethoscope to auscultate the heart in a young man presenting with a stroke? After all, that is what a cardiology consult is for! Who needs a stethoscope to auscultate the carotid arteries for a bruit? Just order a carotid Doppler or, even better, a magnetic resonance angiogram of the neck and while at it might as well order a magnetic resonance angiogram of the intracranial vasculature too. The Wartenberg pinwheel is already extinct and the percussion hammer seems to be heading that way too. After all, who cares whether there is a slight asymmetry in the deep tendon reflexes? C. Miller Fisher, arguably one of the best bedside physician scientists, impressed on his trainees to “make the patient’s bedside your laboratory.”2 So while I agree with Dr Berger’s impassionate plea to our colleagues in other medical specialties not to abandon their clinical skills of observation, palpation, percussion, and auscultation, we have to first put our own house in order or else the last beside physician scientists too shall soon go the way of the dinosaurs.

Topics

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

300 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs
brightcove.createExperiences();