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Great summary Reem. We had a good post-round discussion with Drs. Ovtcharenko and Poon. One of the things that I believe is emphasized at various levels of training of physicians is the need to obtain a good history and perform a thorough physical examination. This critically informs the likely diagnosis, testing and subsequent management of patients. The level of training and experience of a physician plays a key role in informing the number and type of tests requested. As we heard from grand rounds ordering many tests does not necessarily mean one has covered all the bases, neither does ordering fewer tests show how prudent one is or vice versa. The main message I believe was that one should be able to give a plausible reason for requesting a test based on a patient's presentation. I would be curious to hear the opinions of physicians at various levels of training and experience as well, on the many factors that influence their decision making about tests.

Edwin Ocran

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