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The Clinical Record in Medicine Part 1: Learning from Cases*
- Stanley J. Reiser, MD, PhD
Excerpt
The clinical case record freezes in time that episode in life called illness. It is a story in which patient and family are the main characters, with the doctor serving a dual purpose as both biographer and part of the plot. The content of this biography varies greatly, reflecting its many purposes: to recall observations, to inform others, to instruct students, to gain knowledge, to monitor performance, and to justify interventions. In this essay, I discuss how clinical cases have shaped and reflected learning and action in medicine and how the document in which these cases are inscribed—the clinical record—has
This 100-word excerpt has been provided in the absence of an abstract.
Article and Author Information
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A version of this essay was presented at a symposium, "The Medical Journal: Past, Present, and Future," held in honor of Edward J. Huth, Editor of Annals of Internal Medicine, on 14 September 1989. Dr. Huth retired as Editor on 30 June 1990. The papers from the symposium will be published in a Festschrift in his honor.
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↵* The second part of the article focuses on twentieth century improvements in the content and purpose of the case record. It will appear in the 1 June 1991 issue.
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Requests for Reprints: Stanley J. Reiser, MD, PhD, University of Texas Health Science Center at Houston, P.O. Box 20708, Houston, TX 77225.
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Current Author Address: Dr. Reiser: University of Texas Health Science Center at Houston, P. O. Box 20708, Houston, TX 77225.
- © 1991 American College of Physicians
