CPAP 1605 Diagnosis - It's Time to Clarify the Term

CPAP 1605 Diagnosis - It's Time to Clarify the Term -...

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Diagnosis It’s Time to Clarify the Term David B. Koch, D.C., Vice President for Professional and International Affairs, Palmer Chiropractic University System This article will argue for a new terminology of diagnosis, namely, use of the term referential diagnosis both within the chiropractic profession and in dialogue with other health care professions. Such a proposal will undoubtedly elicit strong reactions, so let us begin by recognizing that any effort to propose a new phrase, such as referential diagnosis, is based on several epistemological assumptions. First and foremost, let us assume that the motivation of all reasonable parties to the discussion is for the terms we use to unambiguously communicate the meaning of the thought, object or situation to which they refer. Second, let us assume that where there are crucial ambiguities for a term such as diagnosis— widely used in the common domain—a modifier is intended to customize the term for more accurate usage within a narrower domain. Third, let us assume that the chiropractic profession is, in fact, a profession distinctly different from medicine, osteopathy, dentistry, psychology, optometry, podiatry and massage therapy. Chiropractic has its own distinct area of interest, namely subluxation and its relationship to human life, health, function and dysfunction, and its own distinct clinical procedure, the adjustment. Definitions of Diagnosis The primary challenge in discussing diagnosis in chiropractic clinical practice comes from the fundamental contextual dissonance among the various meanings of diagnosis you will find, for example, in Webster’s New Universal Unabridged Dictionary, 2nd Edition. The first definition is "the act or process of deciding the nature of a disease condition by examination." This definition, clearly medical in context, is followed by a definition of diagnosis in a more general context, namely "a careful investigation of the facts to determine the nature of a thing." The third definition completes the specific vs. non-specific dichotomy by defining the outcome of diagnosis as a diagnosis as well, namely "the decision or opinion resulting from such examination or investigation." Thus diagnosis can mean a specific medical decision-making algorithm, or a general investigative process, or the conclusion from either. Sometimes it is helpful, in analyzing the specific utility of a term, to go to the verb form, in this case "to diagnose," for illumination as to the word’s further (or prior) meaning(s). The same dictionary defines the verb "diagnose" as "recognize and identify (a disease, etc.) by examination and observation." In these definitions we can see that the term diagnosis, in its common usage, refers to the process (and the result) of identifying a problem through direct
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interaction (examination and/or observation) with the thing that may have the problem. Furthermore, it is clear that the "problem" that the diagnostician is seeking to identify is determined by the context of the diagnostic examination. This is supported by our experience with the claims of our local "car doctor," who
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This note was uploaded on 11/21/2011 for the course CPAP 1605 taught by Professor Brianflannery during the Fall '10 term at Life Chiropractic College West.

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CPAP 1605 Diagnosis - It's Time to Clarify the Term -...

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