Young’s postulate,1 which says that that the last doctor to see a patient is also the smartest doctor, rings true.
I know of a situation where a hospital doc found metatarsal fractures in a patient three months after an injury. The fractures were missed because of overlying cellulitis, a sufficient cause for pain, erythema and swelling in a patient with uncontrolled diabetes.
Now, in keeping with Young’s postulate, that hospital doc is the smartest doc and has reportedly said to the patient that the rural doctor, the hospital that treated her as an inpatient, and her own family doc (who followed the resolving cellulitis when she returned home), all missed the fractures and shouldn’t have. Maybe. Or maybe this is an example of Young’s postulate at work. But I have to ask myself — have I spoken this way about other physicians? Do we all do it?