Tuesday, January 27, 2015

Dr. Lawrence Weed and the problem oriented medical record

The video below is a medical grand rounds presentation by Dr. Weed at Emory
in 1971.



There are several shots of J. Willis Hurst and Nanette Kass Wenger on the front row starting at 11:39.  Following that presentation Hurst went on to champion the problem oriented medical record.  

At 22:30 Weed points out that we should avoid jumping to a premature diagnosis by stating a problem only at the level of resolution we have at the time pending further data or expertise.

At 33:53 Weed states: “The problem list should not have 'rule outs', question marks or 'probables'; it should be a precise reproducible statement of the problem at the level you can undersstand it and guarantee it no matter how unsophisticated you have to get.”

Even with the problem lists embedded in today's EMR we're not nearly as rigorous in our approach as Weed envisioned 44 years ago.  

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