Dear Neil, true and timely what you wrote: "diagnosis is important and it should be made through basic history & examination and lab tests".
Indeed diagnosis is what is requested to any good doctor, adequate treatment will follow the Therapeutic/Clinical (TCG) Guidelines of that Country.
Unfortunately in the minds of people a 'good doctor' is the one who knows a 'good treatment'. In 2019 we should change.
Let me add few comments:
1) diagnosis must adhere to TCG. One should not formulate extravagant diagnosis, that are not reported in TCG.
2) diagnosis must be communicated to the patient, in writing, on his/her health booklet.
3) diagnostic tests should also adhere to TCG. So, first step is the formulation of the suspected diagnosis, second step is the request of lab tests to verify the suspect. Unfortunately most times diagnosis is omitted and tests are requested instead of it.
Note: diagnostic tests should be scientifically validated. An example: Widal test (Wt) is not a valid test for the diagnose of typhoid, it is obsolete and unreliable.
Unfortunately thousand Wts will be requested tomorrow in Africa, they will cost money to patients, they will result positive (most of them) and antibiotics will be prescribed, unnecessarily. A loss for the patient($), for the country ($) and for medicine.
Greetings from Dodoma
HIFA profile: Massimo Serventi is a long-standing Pediatrician working in Africa since 1982. He currently works on a volunteer basis in an excellent missionary/credited hospital in north Uganda, St. Mary's Hospital-Lacor-GULU. He has worked for several NGOs in 6 African/2 Asian countries. His interests include clinical and community pediatrics, adherence to clinical guidelines and school education as the major determinant of good health. massimoser20 AT gmail.com