The competent practice of medicine is not easy. It takes years of instruction, additional years of closely supervised and limited exposure to the practice of medicine, and continual education and practice to achieve competency, and to remain so. In practice, competency at performing a differential diagnosis (the distinguishing of a disease or condition from others presenting with similar signs and symptoms) requires careful questioning of the patient and hands-on examination.
All competent and appropriately trained physicians—without exception--use the differential diagnosis in determining how to treat their patients. When it is appropriately used, the methodology rarely produces an erroneous conclusion. When it is not employed appropriately — or not employed at all—a physician has breached the applicable standard of care. In other words, he is negligent.
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