Why Physiology Is Critical to the Practice of Medicine: A 40-year Personal Perspective.

Accuracy in diagnosis trumps all other elements in clinical decision making. If diagnosis is inaccurate, management is likely to prove futile if not dangerous. Knowledge of physiology provides a periscope for identifying abnormalities beneath the skin responsible for clinical manifestations on the surface. Expert diagnosticians suspect disorders based on pattern recognition and automatic retrieval of knowledge stored in memory. A superior diagnostician looks at the same findings other clinicians see but thinks of causes that others have not imagined. Solving clinical mysteries depends on a clinician's power of imagination, not the capacity to recite an algorithm or apply a protocol.