Software Programs Help Doctors Diagnose, but Can’t Replace Them -

Posted on by Brandon Klein

The man on stage had his audience of 600 mesmerized. Over the course of 45 minutes, the tension grew. Finally, the moment of truth arrived, and the room was silent with anticipation. Enlarge This Image Jim Wilson/The New York Times Dr. Gurpreet Dhaliwal, left, speaks to a patient in the emergency department at the V.A. hospital in San Francisco as Dr. Michael Nejad listens in. Jim Wilson/The New York Times EXPERT DIAGNOSTICIAN Dr. Gurpreet Dhaliwal, right, consulting with Dr. Michael Nejad at the San Francisco V.A. Medical Center. Readers’ Comments Readers shared their thoughts on this article. Read All Comments (231) » At last he spoke. “Lymphoma with secondary hemophagocytic syndrome,” he said. The crowd erupted in applause.

Professionals in every field revere their superstars, and in medicine the best diagnosticians are held in particularly high esteem. Dr. Gurpreet Dhaliwal, 39, a self-effacing associate professor of clinical medicine at the University of California, San Francisco, is considered one of the most skillful clinical diagnosticians in practice today.

The case Dr. Dhaliwal was presented, at a medical  conference last year, began with information that could have described hundreds of diseases: the patient had intermittent fevers, joint pain, and weight and appetite loss.

To observe him at work is like watching Steven Spielberg tackle a script or Rory McIlroy a golf course. He was given new information bit by bit — lab, imaging and biopsy results. Over the course of the session, he drew on an encyclopedic familiarity with thousands of syndromes. He deftly dismissed red herrings while picking up on clues that others might ignore, gradually homing in on the accurate diagnosis.