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    Area of Science:

    • Medical diagnosis
    • Clinical practice
    • Symptom presentation

    Background:

    • Discrepancy exists between theoretical symptom-disease links and personal patient presentations.
    • Investigating this gap is crucial for understanding diagnostic competence in primary care.

    Purpose of the Study:

    • To investigate the clinical significance of the gap between theoretical and practical symptom interpretation.
    • To assess the development of practice-oriented diagnostic competence in general practitioners.

    Main Methods:

    • Thirty-three general practitioners and eleven trainees/locums provided diagnostic judgments.
    • Judgments were made first from written symptom descriptions, then from video recordings of patient presentations.
    • A reference group with full clinical data served as a comparison.

    Main Results:

    • Doctors' diagnostic judgments shifted, with psycho-social factors becoming more prominent after viewing video recordings.
    • This shift increased diagnostic discrepancy (p < 0.00003) for organic symptoms compared to a reference group.
    • The hypothesis that video recordings would improve diagnostic accuracy was not confirmed.

    Conclusions:

    • A significant gap exists between medical theory and practice in diagnostic judgment.
    • Psycho-social stereotypes, rather than integrated symptom presentation, heavily influenced early diagnostic judgments.
    • Emotional expressions and social characteristics were prioritized over holistic symptom assessment.