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RFP Journal of Hospital Administration

Volume  4, Issue 1, January-June 2020, Pages 13-18
 

Original Article

Prognostication: An art forgotten

Bidita Khandelwal, Sumit Kar, Vijay P Singh

1Professor, Department of Medicine, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, 2Professor, Department of Community Medicine, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok,3Associate Professor, Physiotherapy, KMC Mangalore, Manipal Academy of Higher Education, Karnataka.

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Abstract

Dr. Christian Sinclair, Medical Director of the Providence Medical Centre Palliative Care Team, Kansas defined Medical Prognostication as “a prediction of future medical outcomes of a treatment or a disease course based on medical knowledge”. Some confuse it with ‘fortune telling’. But it is actually fore seeing or foretelling and not talking on behalf of God as the future events are neither created by doctors nor is there a divine angle to it. Of the three main pillars of clinical medicine - diagnosis, prognosis and treatment, the most difficult and unfortunately most neglected is prognosis. Several prediction tools and indices are available but it is important to remember the prognostication triad (disease factors, extraneous factors and treatment modalities available) for proper application of these mathematical tools. Formulating accurate predictions and communicating them effectively can not only help patient and his family to take judicious decisions especially in emergency situation and end of life care but also reduce the miscommunication which is often a reason for dissatisfaction among the patient. Prognostication is a dying art, a lost skill and what Hippocrates had written in 400 BC “Declare the past, diagnose the present, foretell the future; practice these arts” is the need of the hour. The skill needs
to be understood, learnt and practised in order to master it.

Key words: Art of Medicine; Prediction tools; Prognostication.
 


Corresponding Author : Bidita Khandelwal