12/2/07

Frustrating idioms of the medical profession
First in an endless series.

"workup": tests, imaging, and the like which doctors use to analyze the cause of or prognosticate a given condition. "He had a full workup": the doctors did the tests they thought indicated. Unfortunately, when one uses "workup"without thinking, it can appear that all doctors agree what tests should be done, or that the tests are sufficient. "Had a cardiac workup" does not usually mean "exhaustively risk-stratify a patient for cardiac disease, determine its etiology, and plan for treatment," but rather "was ruled out for acute coronary syndrome [heart attack] or arrythmias."

That's first off. Second is the philosophy of medicine that "workup" implies: the body is a machine, lying there broken, and we approach with our tests to tinker until whatever broken part is repaired. Sometimes this philosophy is appropriate, but more often than not the patient is left dissatisfied after the "workup is negative."

Next up in frustrating idioms: "so we can see what's going on." ("Just get a CT scan of the abdomen so we can see what's going on.")

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