Scan first, ask questions later?

Taking stock after two years of the covid-19 pandemic, it comes as no surprise to discover that demand for medical imaging is higher than ever. Historical under provision of imaging by the NHS has made this more or less inevitable, but changes in clinical practice have also contributed.In the past, the process of medical diagnosis followed a clear formula. Taking a careful history was followed by the conduct of a full examination—these were the precise words we were taught to use—and then, if necessary, some “special tests” were carried out to confirm or refute the diagnosis suggested from the history and examination. For better or for worse, things have changed. “Get a scan and then I’ll see the patient” has become a familiar injunction. A variety of innovations in practice designed to speed up diagnostic pathways, including the growth of remote consultations, mean that a diminishing proportion of the patients…
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