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Which field of medicine is most "algorithm" like?

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17 hours ago, chateau22 said:

i.e. following algorithms is a major part of your discipline



I feel like algorithms are a big thing in "diagnostic" specialties, so think hem/onc, radiology, cardiology, ID,... but also EM, and even surgical specialties has lots of algorithms (especially in pre-op and post-op) to reduce possibility of errors. But I think all specialties would involve algorithms to standardize care and reduce chances of error.

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Almost all medical decision-making across every specialty comes down to applying heuristics on some level—the difference is if someone has published good data on it (forming guidelines that you can follow) or if you have to rely on the heuristics you've developed based on your own (or your attending's) experiences.

However there are specialties where a large amount of time is not spent on medical decision-making. Any procedural specialty (surgery/IR/medical procedural subspecialties) will more frequently encounter unique acute situations that require on-the-spot thinking & problem-solving during procedures. There are also specialties that often deal with rare conditions or atypical manifestations that do not have good guidelines/consensus (specialized paeds). Specialties dealing heavily with the spatial effects of tumours & oncology also for similar reasons have to think outside the box (rad onc, surg onc, radiology.).

Based on my experience, FM and EM rely heavily on decision-making heuristics due to large volumes of undifferentiated patients presenting with a variety of issues, and the fact that the decisions regarding definitive diagnosis & management of unique cases are often made by a consultant service

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ER in well resourced areas are surprisingly algorithmic, but even then there will be many times where theres no algorithm to follow and you need to make a clinical decision. I mean ultimately, this is the reason doctors are doctors, to be able to have the knowledge to make decisions that don't follow an algorithm.  

Cardiology as well is pretty algorithm based due to the amount of research done in the field.

Despite all that, physicians as a whole are probably still one of the least algorithm based fields out there. 

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I think ER if you have good specialist support is a series of decision making trees most of the time to determine admit/non-admit. There is still some clinical judgement though for edge cases. Some types of specialized clinics can be pretty algorithmic too. Anything where it's just the same type of consult can be streamlined.

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