Exclude

You may argue it does no harm to ask our colleagues to acquire better equipments and do a better service.

On that, you are wrong.

As Robert Merton stated: Any purposeful action will produce some unanticipated or unintended consequences.

But this time the consequence is quite anticipated. From now on, when you ask the colleague from that another department for an opinion, they would always suggest doing something more sophisticated because XXX and YYY could not be excluded.

Of course, how often could we say with absolute confidence that everything else has been excluded ? Even if a test is 100 percent reliable, you still run the risk of mixing up with the result from another patient.

And our life - as well as our patients' - would be wasted in the endless list of further investigation.

Alas, on that final certificate, the cause of death would be put down as paranoid psychosis.

PS. One real story I remember vividly from my days of being a trainee: A patient had prolonged fever of unknown cause. A senior microbiologist came and offered a possible explanation. He went on and wrote in the case notes: This patient needs a post-mortem examination to confirm the diagnosis.