The most important task of the consultation is to make the diagnosis, as this is crucial for prognosis and treatment. In general practice an understanding of the psychological and social aspects of a problem are as vital for making a successful diagnosis as a grasp of the purely physical features of illness.
For up to 50% of patients who present in general practice, a firm diagnosis based on pathology may not be possible. Where diagnosis at this level cannot be achieved, working diagnoses are often expressed at a lower level in terms of the patient's symptoms, signs or problems.
A diagnosis is the current statement of probability about the cause of an illness rather than of absolute certainty. As such it must be regarded as provisional unless more evidence is available or until there is no longer a need for a diagnosis at all.
Management decisions often have to be taken on an assessment of symptoms, signs or problems without a definite diagnosis being made.
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