Before coming to my point i want to highlight the concept of P-drug that we read in pharmacology during our undergraduate days. The P-drug concept includes the name of a drug, dosage form, dosage schedule and duration of treatment for a specified condition. This thing helps a physician to handle pharmacological concepts and drug-related data in an effective manner by developing one's own set of P-drugs. so instead of prescribing different drugs in same group, physician sticks to one particular drug from the group. This helps in better understanding of that particular drug.
While doing my post graduation i have got chance to sit with different teachers and learn from them. And over time i have realized one particular guy makes diagnosis from a list of say 50-200 conditions ( No. of entries in list depends on competency of that doctor... More entries..better Clinician!!) And interestingly this list differs for different clinicians. I have noticed that a certain diagnosis is made by a particular doctor only- other guys almost never make this particular diagnosis. This should not be a problem where a diagnostic tests is available. But this becomes an issue in dermatology where most of the conditions are diagnosed clinically. Diagnostic tests are either not confirmatory, not easily available or not affordable. So the problem!! Its confusing for beginners like us.
I have always believed one tends to follow one particular teacher while learning medicine. Medicine is not learned from the books, but from the teacher. Its like creating a intellectual clone- Both the doctor and the " intellectual cloning process'' can be good or bad. So our clinical acumen definitely depends on who we decide to follow. And this is where concept of "P- diagnosis" matters- at least to me. It helps me in deciding whose "intellectual clone" i wanna be!!
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