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4 Clinical skills for avoiding overdiagnosis
  1. Stefan Hjörleifsson,
  2. Eivind Meland
  1. University of Bergen, Bergen, Norway


This workshop will focus on clinical skills for helping patients without over-diagnosing in a society where patients are increasingly framed as consumers and there is an escalating and unsustainable demand for healthcare.

Medical knowledge is usually conceived as intrinsically good and desirable, while at the same time being value neutral, i.e. pertaining to facts that have nothing to do with value judgments and political governance.

In the workshop we will explore an alternative approach, emphasizing the relational aspects of medical knowledge as it is negotiated in clinical encounters and in society. We suggest that in many situations a functional conception of illness and medical care is preferrable to an essentialist and descriptive one. Thus, it can often be more useful to ask: ‘how can we improve the functional capacity of this person?’ rather than ‘how can we prove whether the patient has this or that disease?’

Our main clinical example will be a well-trained young man who consults with his doctor because his fitness device has alerted him that some of his training sessions are sub-optimal. We will seek ways to increase the patient’s ability to deal with life challenges with less recourse to medical diagnoses and treatment. The workshop will offer short training sessions and demonstrations, while we also reflect upon the reframing of the ethical demands in medical care.

Objectives Promote clinical skills emphasizing functional ability and individual values.

Method Demonstrations, group discussions, exercise in triads, plenum dicussions.

Results Promote clinical skills and ability to judge when a descriptive approach is relevant, and when a functional approach is more applicable.

Conclusions Clinical medicine needs an ethical demand that promotes functional ability in addition to disease diagnosis and treatment.

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