Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Jean-Pierre Usdin
American Hospital of Paris, France
Keynote: J Clin Exp Cardiolog
Professor Fred Siguier (1909-1972) a major physician in the 50ﾃ｢ﾂ?ﾂ? use to start a patientﾃ｢ﾂ?ﾂ?s exam saying ﾃ｢ﾂ?ﾂ?Tell me exactly, precisely, in which circumstances your health problem startedﾃ｢ﾂ?ﾂ Professor Siguier suffered of progressive blindness. So he asked to his assistants to make a full examination and to report their findings to their masterﾃ｢ﾂ?ﾂ?s sagacity. People with rare, but not only, diseases came from everywhere, seeking for Siguierﾃ｢ﾂ?ﾂ?s perceptiveness to make clinical diagnosis he was a legend, the father of Internal Medicine. Of course it is an old story and so clinical exam. Thing are not the same actually, medical history and searching for a splenomegaly, describing cardiac murmur are obsolete. X-rays, Ultrasounds are doing this job. The question is where is the relationship between physician and his (her) patient? The answer is in the computer sir! No need for making a full history, it is in the patientﾃ｢ﾂ?ﾂ?s file, no need to point out a specific symptom, it is in the Medical report. Time is money: ask for all the laboratory tests and most imaging at the same time ﾃ｢ﾂ?ﾂ?in a parallel wayﾃ｢ﾂ?ﾂ we will discuss after of the resultsﾃ｢ﾂ?ﾂｦand the discovery of ﾃ｢ﾂ?ﾂ?abnormalitiesﾃ｢ﾂ?ﾂ we were not searching! However, what needs the patient from his doctor is: physicianﾃ｢ﾂ?ﾂ?s attention. The patient likes the palpation of his (her) abdomen, the listening of his (her) lungs, feeling doctorﾃ｢ﾂ?ﾂ?s hands on his (her) body searching for an abnormality ﾃ｢ﾂ?ﾂ?it hurts here doctor!ﾃ｢ﾂ?ﾂ Considering efficiency/cost ratio clinical exam is without any doubt the leader, leaving far away RMI, specific and expensive lab tests. ﾃ｢ﾂ?ﾂ?Ecoutez le malade, il vous donne, vous offre gﾃ?ﾂｩnﾃ?ﾂｩreusement le diagnostic.ﾃ｢ﾂ?ﾂ (Listen to the patient, he gives you, he generously offers to you the diagnosisﾃ｢ﾂ?ﾂ Used to say Fred Siguier.
Jean Pierre Usdin MD., is a Former Internal of the Hospitals of Paris, Former Head of clinic, Assistant of the Hospitals of Paris, Former consultant in scientific committee of medical Journal CONSENSUS and previous Chief of the cardiologic department of American Hospital of Paris (2006-2012). He is currently renowned Cardiologist at American Hospital of Paris, Member of European Society of Cardiology, Member of French Society of Cardiology. Being a Journalist and Blogger in Medscape France (From 2010) he has blogs dedicated to general cardiology: reports discussions and notes about trials, cardiology congresses, live-comments on 2015 ESC congress in London.
Email: jusdin@wanadoo.fr