A frequent occurrence in front line medicine as practice by family physicians, internists, and emergency room physicians is the patient’s demands for laboratory proof of almost any diagnosis, whether it’s peptic disease or a fractured rib. Or even a sprained ankle. Articles have been written on the examination of the ankle, taking into account the type of injury and whether an x-ray will prove helpful. ER physicians who are experts in this diagnosis are not allowed to make clinical diagnosis by the patients who demand an x-ray. It the physician spends time explaining the reason for no further tests, the patient will listen politely and still demand an x-ray.
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