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Errors in gastro-enterologic diagnosis

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The specialty of gastro-enterology occupies a wide area in the field of medicine and requires an elaborate background. The proper practice of this specialty demands a peculiarly wide experience in general medicine, a keenly analytical mind, and a willingness to embrace the new, but only when that ‘new’ gives evidence of correlation with all that has gone before. Many men have been induced to enter gastro-enterology who are fitted neither by training nor inclination for the proper performance of its most exacting requirements. Our calling has been cheapened, and a reproach cast upon all those who have long striven to maintain the standards thus ruthlessly degraded.

The application of the X-ray to gastro-intestinal diagnosis has offered peculiarly easy conditions for inefficiency and fraud to creep in, and for ignorance and egotism to usurp the position which properly belongs to those who have raised the standards now overthrown. It has been demonstrated that gastrointestinal roentgenography, unallied with roentgenoscopy, and uninterpreted by comparison with the findings of the amemnesis, the physical exploration and the laboratory analysis, is bound to be full of errors.

The confusion of standards existing today in gastro-enterology should be remedied. A legal definition for a gastro-enterologist should be established by suitable medical legislation, as has been done in several other specialties. The man who desires to assume that title should be compelled to submit evidence of his fitness to a competent board. Long practice in general medicine, close association with clinical gastro-enterology in a properly conducted clinic, with post-graduate work supervised by competent authorities — these should be the least of the pre-requisites for registration as a specializing gastroenterologist. Until such a standard has been legally established confusion will continue to reign, and gastro-intestinal diagnosis will continue to present the contradictions and confusions which it has been the intention of this paper to present for criticism and correction.

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Golob, M. Errors in gastro-enterologic diagnosis. American Journal of Digestive Diseases and Nutrition 4, 512–516 (1937).

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