The Expert Clinician

Why did I write "The Expert Clinician?"

During my career I noticed that the perceived value of the consultation among trainees has declined and the reliance on guidelines and tests increased. This trend is self-fulfilling because, as the perceived value of the consultation has declined the quantity and quality of the information learnt from the consultation has declined, so that it is often little better than a box-filling exercise. Paradoxically, as more guidelines, investigations and treatments have become available, and as patients have become more knowledgeable and opinionated, the importance of the consultation in the care pathway has increased. As trainees gain experience and expertise, they realise this and learn how to maximise the value of the consultation to ensure it is meaningful: meaningful for both the patient and the clinician. This led me to ask, what is wrong with the current format and what can be done to help trainees bridge the divide? "The Expert Clinician" was written to help trainees become better clinicians, to bridge the divide between the traditional clerking learnt by students and the methods used by experienced clinicians, to bridge the divide between a "textbook" knowledge of medicine and the basic sciences and the clinical reality.

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