Abstract
Dr. Jack House is a fictitious infectious disease fellow who has been allowed to practice superficial and potentially harmful patient evaluations because attending physicians are too busy to adequately supervise him. His consultations on four critically ill patients have been performed in haste and recommendations have been based on faulty reasoning with inadequate data. He has failed to incorporate microscopy into his thought process and his clinical notes are overly brief, poorly written, and call for inappropriately broad-spectrum antimicrobial therapy. His consultation style is contrasted with real examples of patients who were evaluated by an infectious disease consultant who relied heavily on clinical exam and microscopic findings to arrive at an accurate diagnosis and to give recommendations for appropriate antimicrobial therapy. The article is a commentary on an increasingly pervasive type of infectious disease practice.
Highlights
Dr Jack House is a fictitious infectious disease fellow who has been allowed to practice superficial and potentially harmful patient evaluations because attending physicians are too busy to adequately supervise him. His consultations on four critically ill patients have been performed in haste and recommendations have been based on faulty reasoning with inadequate data
The article is a commentary on an increasingly pervasive type of infectious disease practice. It was November 30th and today his beeper had vibrated so many times that the first signs of a friction burn had developed over the right iliac crest of Jack House MD, first-year ID fellow at Summa Cum Laude University Medical Center
Dr House felt comforted by his assumption that the official laboratory and X-ray findings would tell him all he really needed to know about these patients
Summary
Dr Jack House is a fictitious infectious disease fellow who has been allowed to practice superficial and potentially harmful patient evaluations because attending physicians are too busy to adequately supervise him. His consultation style is contrasted with real examples of patients who were evaluated by an infectious disease consultant who relied heavily on clinical exam and microscopic findings to arrive at an accurate diagnosis and to give recommendations for appropriate antimicrobial therapy.
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