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I had another doctors appointment today for an ongoing but undiagnosed issue. Doctors deal with the patient’s medical ailments and biology but they must do so primarily through dialogue with the patient. Their dialogue skills are highly trained. Listening to patients and understanding them is crucial to their work in diagnosing and treating. This dialogue is a specific hierarchy of doctor and patient where the doctor is the expert in medical knowledge but the patient is the expert of their own body and their dialogue is to achieve the outcome of diagnosis and treating according to the patient’s wishes. There is a diagnostic process to follow of ruling things out and this involves a series of questions and tests. Like in an interview situation where the answer to one question might result in altering the course of the conversation, a medical consultation starts of at the basics and follow a checklist of questions which might add a tangential checklist or might divert to another checklist based on the dialogue. The patient may also have questions about the tests, expectations, prognosis. The information exchange is two way and the current policy is patient-centred, informed choice.

Today’s dialogue resulted in an xray.