The Power of Diagnosis

Not all that long ago, almost any medical diagnosis was feared. Today diagnoses are sought after as frequently as they are avoided. A diagnosis can be the gateway to needed services or it can stigmatize the patient—sometimes the same diagnosis does both. Meanwhile the number of variations in normal health and behavior that receive medical diagnoses continues to expand. This month’s contributors explore the “medicalizing” of common human problems—from shyness and addiction to weight gain and baldness —and help us make sense of the power that medical diagnosis has in our everyday lives. 

Volume 13, Number 12: 847-924 Full Issue PDF
  • From the Editor
    Dec 2011

    What Is It?

    Shara Yurkiewicz
    A patient visit to the physician seldom feel complete without an answer to that question, an answer that can affect the course of a life.
    Virtual Mentor. 2011;13(12):849-851. doi: 10.1001/virtualmentor.2011.13.12.fred1-1112.
  • Case and Commentary
    Dec 2011

    Is Physician Self-Disclosure Ever Appropriate?

    James E. Sabin, MD
    Studies have found that, contrary to what their physicians may have expected, patients were less satisfied with primary care appointments in which physician self-disclosure occurred and reported feeling less warmth, comfort, friendliness and reassurance in those appointments.
    Virtual Mentor. 2011;13(12):852-855. doi: 10.1001/virtualmentor.2011.13.12.ccas1-1112.
  • Case and Commentary
    Dec 2011

    When Diagnosis is a Double-Edged Sword

    Mary Lynn Dell, MD, DMin
    Diagnosing a child with borderline signs of Asperger disorder can be a gateway to needed interventions and services and also a label that stigmatizes or influences the child’s development.
    Virtual Mentor. 2011;13(12):856-860. doi: 10.1001/virtualmentor.2011.13.12.ccas2-1112.
  • Case and Commentary
    Dec 2011

    A Virtue Ethics Approach to Framing Troublesome Diagnoses

    Cynthia Geppert, MD, MA, PhD, MPH
    Virtue ethics can point the way toward an appropriate approach to communicating a diagnosis of nonepileptic seizures.
    Virtual Mentor. 2011;13(12):861-865. doi: 10.1001/virtualmentor.2011.13.12.ccas3-1112.
  • In the Literature
    Dec 2011

    Ethical Issues in the Early Diagnosis of Alzheimer Disease

    Matthew E. Growdon
    The early diagnosis of Alzheimer disease is a boon in that it enables advance planning, but that planning process can engender conflict between respect for future-oriented autonomy and future welfare.
    Virtual Mentor. 2011;13(12):868-872. doi: 10.1001/virtualmentor.2011.13.12.jdsc1-1112.
  • Health Law
    Dec 2011

    A Physician's Guide to Social Security Disability Determinations

    Valarie Blake, JD, MA
    The words doctors write can have far-reaching consequences, particularly legal ones, for their patients. This article will help physicians understand the power of diagnosis in one area where their counsel is often sought—social security disability determination.
    Virtual Mentor. 2011;13(12):885-889. doi: 10.1001/virtualmentor.2011.13.12.hlaw1-1112.
  • State of the Art and Science
    Dec 2011

    Patient-Centered Revisions to the DSM-5

    Emily A. Kuhl, PhD, David J. Kupfer, MD, and Darrel A. Regier, MD, MPH
    Revisions to the Diagnostic and Statistical Manual of Mental Disorders aim to ground diagnoses in empirical evidence, make them less stigmatizing, and incorporate assessments of patients' functioning over time.
    Virtual Mentor. 2011;13(12):873-879. doi: 10.1001/virtualmentor.2011.13.12.stas1-1112.
  • State of the Art and Science
    Dec 2011

    Challenging Diagnoses

    Barry DeCoster, PhD
    Without reflection and openness, physicians can be swept up into thinking that current disease categories and diagnoses arrived at through the differential diagnosis technique are certain and permanent.
    Virtual Mentor. 2011;13(12):880-884. doi: 10.1001/virtualmentor.2011.13.12.stas2-1112.
  • Policy Forum
    Dec 2011

    Medicalizing Obesity: Individual, Economic, and Medical Consequences

    George L. Blackburn, MD, PhD
    Given the ever-rising costs associated the condition and its associated comorbidities, perhaps it's time to recognize obesity as a medical problem.
    Virtual Mentor. 2011;13(12):890-895. doi: 10.1001/virtualmentor.2011.13.12.pfor1-1112.
  • History of Medicine
    Dec 2011

    The Evolution of Addiction Medicine as a Medical Specialty

    David E. Smith, MD
    The medicalization of addiction has greatly improved identification, early intervention, and referral to appropriate treatment.
    Virtual Mentor. 2011;13(12):900-905. doi: 10.1001/virtualmentor.2011.13.12.mhst1-1112.
  • Viewpoint
    Dec 2011

    The Pharmaceutical Industry's Role in Defining Illness

    Elizabeth A. Kitsis, MD, MBE
    The pharmaceutical industry's influence on the process of defining illness can be positive, as when drug companies increase public awareness of disease and develop effective therapies, or negative, if it pushes the boundaries of illness too far in pursuit of profit.
    Virtual Mentor. 2011;13(12):906-911. doi: 10.1001/virtualmentor.2011.13.12.oped1-1112.