The Curious Side Effects of Medical Transparency

One afternoon not long ago, I sat entering notes into a patient's medical record. She was in her forties, and her labs showed anemia. The causes of anemia range from menstruation to cancer, and so pinpointing the correct underlying diagnosis is critical. Physicians are trained to formulate a full roster of possibilities, known as the differential diagnosis, and then to work down the list systematically. We're taught to cast a wide net--celiac disease, parasitic infections, thalassemia, lead poisoning, liver disease, B12 deficiency, myeloma, sickle-cell disease, G6PD deficiency--because you'll never make a diagnosis if you haven't included it in your differential.